Miracle Workers C.L.a. LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

PCH001449 Issued in GA

Legal business name

MIRACLE WORKERS C.L.A. LLC

Practice address

5 Vineyard Haven Dr
Pooler, GA 31322-8250

Phone

(912) 247-8424

NPI assigned

Oct 13, 2011

Organization subpart

No

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

Authorized official

Name

Melissa Green

Title

Owner

Phone

(912) 247-8424

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1851676506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7071",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314187071",
            "telephone_number": "912-247-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 VINEYARD HAVEN DR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313228250",
            "telephone_number": "912-247-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE WORKERS C.L.A. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-247-8424"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "PCH001449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Pooler, GA
• Providers in Pooler, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.