A Miracle Group, Llc | |
3706 Winchester Dr Portsmouth VA 23707-4332 | |
(757) 675-8763 | |
(757) 483-6525 |
Full Name | A Miracle Group, Llc |
---|---|
Speciality | Community/behavioral Health |
Location | 3706 Winchester Dr, Portsmouth, Virginia |
Authorized Official Name and Position | Lisa Outland (CEO) |
Authorized Official Contact | 7576758763 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
A Miracle Group, Llc 4621 Mallard Cres Portsmouth VA 23703-2240 Ph: (757) 675-8763 | A Miracle Group, Llc 3706 Winchester Dr Portsmouth VA 23707-4332 Ph: (757) 675-8763 |
NPI Number | 1932826906 |
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Provider Enumeration Date | 10/20/2022 |
Last Update Date | 10/20/2022 |
Certification Date | 10/20/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932826906 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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