Organization
MIRACLE HOUSES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATSY YOUNG CAMP BA (EXECUTIVE DIRECTOR)
(704) 535-4447
Entity
Organization
Contact information
Practice address
7508 E INDEPENDENCE BLVD, SUITE 119, CHARLOTTE, NC 28227-9473
(704) 535-4447
Mailing address
7508 E INDEPENDENCE BLVD, SUITE 119, CHARLOTTE, NC 28227-9473
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
111204
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457522930
—
NC
05
—
1649310400
—
NC
05
—
1801023114
—
NC
05
—
1881734275
—
NC
Enumeration date
12/29/2010
Last updated
12/29/2010
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