Organization
MIRACLE HOUSES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATSY Y. CAMP (EXECUTIVE DIRECTOR)
(704) 535-4447
Entity
Organization
Contact information
Practice address
2004 TWIN AVE, GASTONIA, NC 28052-1369
(704) 535-4447
(704) 535-4476
Mailing address
7508 E INDEPENDENCE BLVD, SUITE 119, CHARLOTTE, NC 28227-9473
(704) 535-4447
(704) 535-4476
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MHL036287
—
NC
Enumeration date
04/14/2011
Last updated
05/15/2019
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