NPIMap

Organization Active NPI

Miracle Houses, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Charlotte, NC
National Provider Identifier
1336593698
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
MIRACLE HOUSES, INC.
Practice address
2627 Providence Rd
Charlotte, NC 28211-2238
Phone
(980) 938-8304
NPI assigned
Apr 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Authorized official

Name
Mrs. Patsy Y Camp
Title
Executive Director
Phone
(704) 369-1445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

2627 Providence Rd
Charlotte, NC 28211-2238

Mailing address

2627 Providence Rd
Charlotte, NC 28211-2238
Phone (980) 938-8304

Other identifiers 1

IdentifierTypeStateIssuer
111204MedicaidNC

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

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461283200000",
    "number": "1336593698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 PROVIDENCE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112238",
            "telephone_number": "980-938-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 PROVIDENCE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112238",
            "telephone_number": "980-938-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE HOUSES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "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": "704-369-1445",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111204",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 22, 2016; 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.