Holt Street Miracle Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

13086 Issued in OH

Legal business name

HOLT STREET MIRACLE CENTER

Practice address

420 Holt St
Dayton, OH 45402-6335

Phone

(937) 222-7420

NPI assigned

May 8, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Walter Gilbert

Title

Executive Director

Phone

(937) 222-7420

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1437418647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 HOLT ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454026335",
            "telephone_number": "937-222-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 HOLT ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454026335",
            "telephone_number": "937-222-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLT STREET MIRACLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "937-222-7420",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OH",
            "license": "13086",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "13086",
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "OH",
            "license": "13086",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessika Holmes, MSW, LISW
• Lauren Holmes
• Alana Marie Holsapple
• Lisa Marie Holscher
• Trevor G Holsinger, CRNA
• Derricka Holt
• John E Holt II
• Joshua Holt
• Kenyatta Ja'Cobe Holt
• Lois Holt

• Community/Behavioral Health Agency in Dayton, OH
• Providers in Dayton, OH by specialty
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.