Organization
CHOOCHOOS MIRACLE CORNER CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARINE JULES REV. DR, LPN (ADMINISTRATOR)
(803) 845-8020
Entity
Organization
Contact information
Practice address
1103 BELLEVIEW ST # 104, COLUMBIA, SC 29201-1871
(803) 845-8020
Mailing address
2019 DRIFTWOOD DR, COLUMBIA, SC 29210-6703
(803) 845-8020
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
Other
Enumeration date
10/11/2025
Last updated
10/11/2025
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