Active NPI
Miracle Care
- Home Health Agency
- Wadena, MN
National Provider Identifier
1184302143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- MIRACLE CARE
- Practice address
- 815 6TH St SW
Wadena, MN 56482-1928 - Phone
- (612) 688-7661
- Fax
- (612) 688-7672
- NPI assigned
- Jul 10, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jatty D Zondo
- Title
- Ceo
- Phone
- (612) 688-7661
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Meals Provider | 174200000X | |||
| Case Management Agency | 251B00000X | |||
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Home Health Agency | 251E00000X | Primary | ||
| Community Based Hospice Care Agency | 251G00000X | |||
| Nursing Care Agency | 251J00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Assisted Living Facility | 310400000X | |||
| Adult Care Home Facility | 311ZA0620X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | |||
| Non-emergency Medical Transport (VAN) | 343900000X | |||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X |
Addresses
Primary practice location
815 6TH St SW
Wadena, MN 56482-1928
Mailing address
815 6TH St SW
Wadena, MN 56482-1928
Phone (612) 688-7661
National Provider Directory
National Provider Directory- Tax ID family
- Miracle Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Wadena, MN
- NPI 1821747023
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nursing Care Agency
- Wadena, MN
- NPI 1528716750
Day Training, Developmentally Disabled Services
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727222400000",
"number": "1184302143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 6TH ST SW",
"city": "WADENA",
"state": "MN",
"postal_code": "564821928",
"telephone_number": "612-688-7661",
"fax_number": "612-688-7672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 6TH ST SW",
"city": "WADENA",
"state": "MN",
"postal_code": "564821928",
"telephone_number": "612-688-7661",
"fax_number": "612-688-7672"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIRACLE CARE",
"organizational_subpart": "NO",
"enumeration_date": "2023-07-10",
"last_updated": "2024-09-25",
"certification_date": "2024-09-19",
"status": "A",
"authorized_official_last_name": "ZONDO",
"authorized_official_first_name": "JATTY",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "612-688-7661"
},
"taxonomies": [
{
"code": "174200000X",
"taxonomy_group": "",
"desc": "Meals",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wadena, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.