NPIMap

Organization Active NPI

Wonderful Moving Miracle LLC

  • Foster Care Agency
  • Canton, OH
National Provider Identifier
1558654665
Registry record updated May 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
1523810002 Issued in OH
Legal business name
WONDERFUL MOVING MIRACLE LLC
Doing business as
WMMLLC
Practice address
6657 Carriage Lane Ave NE
Canton, OH 44721-2580
Phone
(330) 354-4844
Fax
(330) 494-3247
NPI assigned
May 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2011

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

Authorized official

Name
Mrs. Glenda Marshall
Title
Ceo
Phone
(330) 354-4844

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 1523810002 OH
Foster Care Agency 253J00000X 1523810002 OH Primary
In Home Supportive Care Agency 253Z00000X 1523810002 OH
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 1523810002 OH

Addresses

Primary practice location

6657 Carriage Lane Ave NE
Canton, OH 44721-2580

Mailing address

6657 Carriage Lane Ave NE
Canton, OH 44721-2580
Phone (330) 354-4844

Other identifiers 1

IdentifierTypeStateIssuer
3101888MedicaidOH

Other names 1

  • WMMLLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306108800000",
    "number": "1558654665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6657 CARRIAGE LANE AVE NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212580",
            "telephone_number": "330-354-4844",
            "fax_number": "330-494-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6657 CARRIAGE LANE AVE NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212580",
            "telephone_number": "330-354-4844",
            "fax_number": "330-494-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONDERFUL MOVING MIRACLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-23",
        "last_updated": "2011-05-23",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-354-4844",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": "1523810002",
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "OH",
            "license": "1523810002",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OH",
            "license": "1523810002",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "OH",
            "license": "1523810002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3101888",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WMMLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2011; 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.