| Miracle Wellness Center Llc | |
|
5320 N 16th St Ste 204212 Phoenix AZ 85016-3220 | |
| (480) 494-7642 | |
| Not Available |
| Full Name | Miracle Wellness Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5320 N 16th St Ste 204212, Phoenix, Arizona |
| Authorized Official Name and Position | Benjamin Magbie (OWNER) |
| Authorized Official Contact | 4804947642 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Wellness Center Llc 5320 N 16th St Ste 204212 Phoenix AZ 85016-3220 Ph: (480) 494-7642 | Miracle Wellness Center Llc 5320 N 16th St Ste 204212 Phoenix AZ 85016-3220 Ph: (480) 494-7642 |
| NPI Number | 1720791239 |
|---|---|
| Provider Enumeration Date | 12/29/2022 |
| Last Update Date | 12/29/2022 |
| Certification Date | 12/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720791239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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