Provider Demographics
NPI:1801688528
Name:MIRACLES OF EDEN, INC.
Entity type:Organization
Organization Name:MIRACLES OF EDEN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OGOCHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:EKLWUEME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-9155
Mailing Address - Street 1:9500 ARENA DR
Mailing Address - Street 2:SUITE 440E
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774
Mailing Address - Country:US
Mailing Address - Phone:240-486-9155
Mailing Address - Fax:
Practice Address - Street 1:9500 ARENA DR
Practice Address - Street 2:SUITE 440E
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774
Practice Address - Country:US
Practice Address - Phone:240-486-9155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty