NPIMap

Organization Active NPI

Miracle Houses, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Charlotte, NC
National Provider Identifier
1013518323
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
MIRACLE HOUSES, INC.
Practice address
6120 Eagle Peak Dr
Charlotte, NC 28214-2224
Phone
(704) 535-4447
Fax
(704) 535-4476
NPI assigned
Nov 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Patsy Y. Camp
Title
Executive Director
Phone
(704) 535-4447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

6120 Eagle Peak Dr
Charlotte, NC 28214-2224

Mailing address

9307 Monroe Rd Ste K
Charlotte, NC 28270-1485
Phone (704) 535-4447

Other identifiers 1

IdentifierTypeStateIssuer
049163MedicaidNC

Other names 1

  • MIRACLE HOUSES INC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL MiracleHouse Direct

National Provider Directory

National Provider Directory
Tax ID family
Miracle Houses Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

9307 Monroe Rd
Ste K
Charlotte, NC 28270

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1013518323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9307 MONROE RD STE K",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282701485",
            "telephone_number": "704-535-4447",
            "fax_number": "704-535-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 EAGLE PEAK DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282142224",
            "telephone_number": "704-535-4447",
            "fax_number": "704-535-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE HOUSES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "PATSY",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-535-4447"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049163",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MiracleHouse",
            "affiliation": "N",
            "endpointDescription": "MircleHouse",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "320 Winchester Rd",
            "city": "Troutman",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281669644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MIRACLE HOUSES INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MIRACLE HOUSES INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.