Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miracle on 29th Street

Organization Case Manager/Care Coordinator · NPI 1255835997

Miracle on 29th Street is a Case Manager/Care Coordinator in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2018.

Licensed in
AZ
In the registry since
2018

Practice location Address checks out

18210 N 29th St
Phoenix, AZ 85032-1103
Phone: (480) 302-1101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X · Licence AL10509H (AZ)

Record details

NPI number1255835997
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Troy Berkley — Owner · (480) 302-1101
Other names Koala-D Meds
NPI enumeratedMarch 19, 2018
Last updated in NPPESSeptember 12, 2025
Mailing address18210 N 29th St, Phoenix, AZ 85032-1103

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