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MIRACLE HOUSE INC NPI 1184188104


NPI Information

NPI: 1184188104
Provider Name: MIRACLE HOUSE INC

Former Legal Business Name: MIRACLE HOUSES INC

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
332 WINCHESTER RD
TROUTMAN, NC
ZIP 28166
Phone: (704) 535-4447
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MIRACLE HOUSE INC is a residential treatment facility emotionally disturbed children in Troutman, NC. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. MIRACLE HOUSE INC NPI is 1184188104. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Miracle Houses Inc.

The provider's business location address is:

332 WINCHESTER RD
TROUTMAN, NC
ZIP 28166-644
Phone: (704) 535-4447
Fax: (704) 535-4476

The provider's authorized official is Patsy Camp .
The authorized official title is Executive Director and has the following contact phone number (704) 535-4447.

The enumeration date for this NPI number is 1/23/2019 and was last updated on 1/25/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
135184241MEDICAIDNORTH CAROLINA
235184242MEDICAIDNORTH CAROLINA
33518424MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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