| Organization Name: | MIRACLE CARE HOSPICE, INC. |
| NPI Number: | 1871648758 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDDIE LEE (CEO) |
| Mailing Address: | 330 Edgewood Terrace Dr Suite B Jackson |
| State: | MS US |
| Postal Code: | 392066216 |
| Phone Number: | 6019821909 |
| Fax Number: | 6019828177 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 087 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |