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Organization
MIRACLE HOUSE INC
Active
Organization
MIRACLE HOUSE INC
Active
Parent organization
MIRACLE HOUSE INC
Other names
MIRACLE HOUSES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIRACLE HOUSE INC
Authorized official
MRS. PATSY CAMP (EXECUTIVE DIRECTOR)
(704) 535-4447
Entity
Organization
Contact information
Practice address
332 WINCHESTER RD, TROUTMAN, NC 28166-9644
(704) 535-4447
(704) 535-4476
Mailing address
7508 E INDEPENDENCE BLVD, STE 119, CHARLOTTE, NC 28227-9473
(704) 535-4447
(704) 535-4476
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3518424
—
NC
05
—
35184241
—
NC
05
—
35184242
—
NC
Enumeration date
01/23/2019
Last updated
01/25/2019
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