NPIMap

Organization Active NPI

Miracle Houses, Incorporated

  • Community/Behavioral Health Agency
  • Atlanta, GA
National Provider Identifier
1154675403
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MIRACLE HOUSES, INCORPORATED
Practice address
260 18TH St NW
Unit 10212
Atlanta, GA 30363
Phone
(704) 315-3895
Fax
(704) 535-4476
NPI assigned
Nov 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Authorized official

Name
Mrs. Patsy Young Camp
Title
Executive Director/Vice President
Phone
(704) 369-1445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

260 18TH St NW
Unit 10212
Atlanta, GA 30363

Mailing address

544 Mulberry St Ste 613
Macon, GA 31201-6324
Phone (704) 315-3895

Other identifiers 1

IdentifierTypeStateIssuer
1861796179MedicaidNC

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527811200000",
    "number": "1154675403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 MULBERRY ST STE 613",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016324",
            "telephone_number": "704-315-3895",
            "fax_number": "704-535-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 18TH ST NW",
            "address_2": "UNIT 10212",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30363",
            "telephone_number": "704-315-3895",
            "fax_number": "704-535-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE HOUSES, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2018-06-01",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "PATSY",
        "authorized_official_middle_name": "YOUNG",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/VICE PRESIDENT",
        "authorized_official_telephone_number": "704-369-1445",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861796179",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.