Miracle Care Manor LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

MIRACLE CARE MANOR LLC

Practice address

9390 Appleton
Redford, MI 48239-1240

Phone

(734) 444-8987

Fax

(734) 725-5466

NPI assigned

Feb 20, 2025

Organization subpart

No

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

Authorized official

Name

Mrs. Petronia Bell

Title

Ceo

Phone

(734) 444-8987

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1144026188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9390 APPLETON",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391240",
            "telephone_number": "734-444-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9390 APPLETON",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391240",
            "telephone_number": "734-444-8987",
            "fax_number": "734-725-5466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE CARE MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "PETRONIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-444-8987",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latonia Mindingall, LBSW
• Margaret Mingo, MA NCC LPC
• Naseem Ayub Minhas
• Kayla Courtney Minor
• Domonique Gabrielle Minter, MA TLLP
• Kayla Misajlovski, PA
• Miss Krystal Cares LLC
• Trupti Daxesh Modi, PT
• Amal Mohamed Mohamed, LLMSW
• David R Monroe, PSY D, LPC

• Adult Care Home Facility in Redford, MI
• Providers in Redford, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.