MIRACLE HEALTH CARE SERVICES (NPI# 1114233715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114233715 |
| Entity Type | Organization |
| Organization Name | MIRACLE HEALTH CARE SERVICES |
| Practice Address |
396 Piedmont Ave Ne Unit 4013 Atlanta GA 30308-3400 |
| Practice Telephone | 6787058075 |
| Mailing Telephone | 6787058075 |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2010-08-20 |
| Authorized Official Name | MR. XAVIER YOUNG (OWNER/ EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7043153895 |
| Authorized Official Credential | B.S. |
| Is Organization Subpart | Y |
| Parent Organization Name | MIRACLE HOUSES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
396 PIEDMONT AVE NE UNIT 4013 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30308-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467015172 | Dyana Conley | Pharmacist | 396 Piedmont Ave Ne, Atlanta, GA 30308-3400 | 2019-04-18 |
| 1992069751 | Atlanta Medical Center | General Acute Care Hospital | 396 Piedmont Ave Ne, Apt. 5005, Atlanta, GA 30308-3400 | 2012-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285165 | Grace Mckinnon Cutchin | Speech-Language Pathologist | 550 Peachtree St. Ne, 9th Floor, Suite 4400, Atlanta, GA 30308 | 2020-08-10 |
| 1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
| 1184254591 | Jordan Cohen | Specialist | 1075 Peachtree Rd, Suite 300, Atlanta, GA 30308 | 2020-01-24 |
| 1104463819 | Gary Sydney Koech IIi | Registered Nurse | Emory Midtown- Davis Fischer Bld 3rd Floor, Rm 3245a, 550 Peachtree Street, N.e., Atlanta, GA 30308 | 2019-12-02 |
| 1639728207 | Shannon Oliver Sullivan | Counselor | 1 Baltimore Pl Nw, Suite 360, Atlanta, GA 30308 | 2019-09-06 |
| 1477110187 | Ariel Alibey | Preventive Medicine | 550 Peachtree St Ne Bldg 4th, Atlanta, GA 30308 | 2019-05-29 |
| 1972075497 | Laura Mcrae | Nurse Practitioner | Emory Center for Critical Care, 550 Peachtree Street, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-21 |
| 1265902134 | Kyle Brooks Kraft | Nurse Practitioner | 550 Peachtree Road, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-04 |
| 1396211025 | Vita Judkins | Pharmacist | 240 Renaissance Pkway Ne, Unit 116, Atlanta, GA 30308 | 2018-10-20 |
| 1407345911 | Caitlin Cundiff | Anesthesiology | 550 Peachtree St Ne Ste 3245b, Atlanta, GA 30308 | 2018-05-09 |
| Find all providers in zip 30308 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952914632 | Brighter Dayz, Incorporated | Community/Behavioral Health | 1016 Howell Mill Rd Nw Apt 4408, Atlanta, GA 30318-5592 | 2020-08-24 |
| 1699387688 | Rise Rehabilitation Services, LLC | Community/Behavioral Health | 738 Highland Park Trl, Atlanta, GA 30350-6706 | 2020-08-20 |
| 1700427820 | Trust2change, LLC. | Community/Behavioral Health | 2900 Chamblee Tucker Rd Bldg 8, Atlanta, GA 30341-4100 | 2019-09-30 |
| 1538712088 | Ferris Healthcare Group | Community/Behavioral Health | 2900 Paces Ferry Rd Se Bldg C, Atlanta, GA 30339-5702 | 2019-07-23 |
| 1245890987 | Soc Integrated Services, LLC | Community/Behavioral Health | 130 Wynfield Way Sw, Atlanta, GA 30331-6837 | 2019-06-15 |
| 1770046740 | Z-one Incorporated | Community/Behavioral Health | 505 Tufton Trl Se, Atlanta, GA 30354-2867 | 2019-04-08 |
| 1003377086 | Chris 180, Inc. | Community/Behavioral Health | 3700 Martin Luther King Dr Sw, Atlanta, GA 30331-3674 | 2019-03-30 |
| 1144790783 | Danielle Smith | Community/Behavioral Health | 880 Glenwood Ave Se Unit 3185, Atlanta, GA 30316-1955 | 2018-11-27 |
| 1073083762 | Michael Pollock | Community/Behavioral Health | 3725 Princeton Lakes Pkwy Sw Apt 7003, Atlanta, GA 30331-5560 | 2018-11-26 |
| 1851881353 | Atlanta Life Journeys Services, LLC | Community/Behavioral Health | 3196 Dogwood Dr, Atlanta, GA 30354-1149 | 2018-05-10 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.