Organization
MIRACLE HOUSES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATSY Y CAMP (EXECUTIVE DIRECTOR)
(704) 535-4447
Entity
Organization
Contact information
Practice address
3316 WAXHAW INDIAN TRAIL RD, INDIAN TRAIL, NC 28079-4233
(704) 535-4447
(704) 535-4476
Mailing address
3316 WAXHAW INDIAN TRAIL RD, INDIAN TRAIL, NC 28079-4233
(704) 535-4447
(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
—
005363
—
NC
Enumeration date
02/07/2017
Last updated
02/07/2017
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