Miracle Home Health South, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MIRACLE HOME HEALTH SOUTH, LLC

Practice address

3216 Friendly LN
Suite D
Haltom City, TX 76117-3600

Phone

(214) 929-4828

NPI assigned

Jan 14, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Barry E Bentle

Title

Member

Phone

(214) 929-4828

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231891200000",
    "number": "1457598310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 136383",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761360383",
            "telephone_number": "214-929-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 FRIENDLY LN",
            "address_2": "SUITE D",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761173600",
            "telephone_number": "214-929-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE HOME HEALTH SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A",
        "authorized_official_last_name": "BENTLE",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "214-929-4828",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.