Miracle Hope Supportive Home Care LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

MIRACLE HOPE SUPPORTIVE HOME CARE LLC

Doing business as

Miracle Hope Supportive Home Care LLC

Practice address

4467 N 85TH St
Milwaukee, WI 53225-5141

Phone

(920) 815-5158

NPI assigned

Jan 31, 2024

Last updated

Jan 31, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cencreaha E Bowman

Title

Ceo

Phone

(920) 815-5158

Specialties & licenses 1

Addresses

Other names 1

• Miracle Hope Supportive Home Care LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1053174391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532102749",
            "telephone_number": "414-275-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4467 N 85TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532255141",
            "telephone_number": "920-815-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE HOPE SUPPORTIVE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "CENCREAHA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "920-815-5158",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miracle Hope Supportive Home Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adrian Miranda, MD
• Hailey Miranda

• Adult Day Care Clinic/Center in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Adult Day Care Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.