| A Miracle Place Inc | |
|
12674 Hoover St Garden Grove CA 92841-4173 | |
| (310) 408-5620 | |
| Not Available |
| Full Name | A Miracle Place Inc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 12674 Hoover St, Garden Grove, California |
| Authorized Official Name and Position | Imelda Lenz (LICENSEE) |
| Authorized Official Contact | 3104085620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Miracle Place Inc 12674 Hoover St Garden Grove CA 92841-4173 Ph: () - | A Miracle Place Inc 12674 Hoover St Garden Grove CA 92841-4173 Ph: (310) 408-5620 |
| NPI Number | 1275319527 |
|---|---|
| Provider Enumeration Date | 09/04/2023 |
| Last Update Date | 09/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275319527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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