Organization
A MIRACULOUS HAVEN INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY WILLRICH (OWNER)
(817) 797-6107
Entity
Organization
Contact information
Practice address
4135 TIMBER VISTA DR, BURLESON, TX 76028-2098
(817) 797-6107
Mailing address
4135 TIMBER VISTA DR, BURLESON, TX 76028-2098
(817) 797-6107
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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