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Organization

MIRACLE HOUSES, INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATSY YOUNG CAMP (EXECUTIVE DIRECTOR/VICE PRESIDENT)
(704) 369-1445
Entity
Organization

Contact information

Practice address
260 18TH ST NW, UNIT 10212, ATLANTA, GA 30363
(704) 315-3895
(704) 535-4476
Mailing address
544 MULBERRY ST STE 613, MACON, GA 31201-6324
(704) 315-3895
(704) 535-4476

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1861796179
NC
Enumeration date
11/07/2012
Last updated
06/01/2018
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