Organization
MIRACLE HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YUSHONDA MIDGETTE BA (OWNERS)
(910) 538-1096
Entity
Organization
Contact information
Practice address
800 SHIPYARD BLVD, SUITE 3, WILMINGTON, NC 28412-6442
(910) 538-1096
Mailing address
800 SHIPYARD BLVD, SUITE 3, WILMINGTON, NC 28412-6442
(910) 538-1096
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7675194
NC
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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