Organization
MIRACLE MAKERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ZOYA GORNOPOLSKY (OWNER)
(252) 331-2174
Entity
Organization
Contact information
Practice address
305 EAST MAIN STREET, ELIZABETH CITY, NC 27909-1200
(252) 331-2174
Mailing address
305 EAST MAIN STREET, ELIZABETH CITY, NC 27909-1200
(252) 331-2174
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-070-057
NC
Other
Enumeration date
03/08/2011
Last updated
07/25/2011
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