| Miracle Houses, Incorporated | |
|
260 18th St Nw Unit 10212 Atlanta GA 30363 | |
| (704) 315-3895 | |
| (704) 535-4476 |
| Full Name | Miracle Houses, Incorporated |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 260 18th St Nw, Atlanta, Georgia |
| Authorized Official Name and Position | Patsy Young Camp (EXECUTIVE DIRECTOR/VICE PRESIDENT) |
| Authorized Official Contact | 7043691445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Houses, Incorporated 544 Mulberry St Ste 613 Macon GA 31201-6324 Ph: (704) 315-3895 | Miracle Houses, Incorporated 260 18th St Nw Unit 10212 Atlanta GA 30363 Ph: (704) 315-3895 |
| NPI Number | 1154675403 |
|---|---|
| Provider Enumeration Date | 11/07/2012 |
| Last Update Date | 06/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154675403 | NPI | - | NPPES |
| 1861796179 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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