Organization
DESTINY & MIRACLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANTOINETTE STEELE MS (CEO/EXECUTIVE DIRECTOR)
(678) 545-7340
Entity
Organization
Contact information
Practice address
2551 PEMBROKE RD, GASTONIA, NC 28054-4712
(678) 545-7340
(704) 691-7044
Mailing address
2551 PEMBROKE RD, GASTONIA, NC 28054-4712
(678) 545-7340
(704) 691-7044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347C00000X
Private Vehicle
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
08/28/2020
Last updated
07/08/2021
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