MIRACLE HOUSE, INC (NPI# 1295909877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295909877 |
| Entity Type | Organization |
| Organization Name | MIRACLE HOUSE, INC |
| Other Organization Name | MIRACLE RECOVERY CENTERS |
| Practice Address |
1997 E Main St Ventura CA 93001-3406 |
| Practice Telephone | 8056487857 |
| Practice Fax Number | 8056487540 |
| Mailing Telephone | 8056487857 |
| Mailing Fax Number | 8056487540 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |
| Authorized Official Name | MR. NORMAN FRANK PATTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8056487857 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | 560007AN | CA | Residential Treatment Facilities |
| N | 324500000X | Substance Abuse Rehabilitation Facility | 56000CN | CA | Residential Treatment Facilities |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
072703 1 | CA | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Miracle Recovery Centers | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | MIRACLE HOUSE, INC. | 214 Beechwood Ave., Bridgeport, CT 06604 |
| Street Address |
1997 E MAIN ST |
| City | VENTURA |
| State | CA |
| Zip Code | 93001-3406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790977619 | Anna Christine Mcdonald | Marriage & Family Therapist | 1997 E Main St, Ventura, CA 93001-3406 | 2007-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952929739 | Christine Yana Barna | Counselor | 641 E Thompson Blvd, Ventura, CA 93001 | 2020-07-08 |
| 1477024222 | 4 Kids 2 Kids | Psychiatric Residential Treatment Facility | 9223 Nye Road, Ventura, CA 93001 | 2018-12-05 |
| 1578046884 | Michelle Aquino | Counselor | 2222 Channel Dr, Ventura, CA 93001 | 2018-09-12 |
| 1700379096 | Terrence Swanson | Counselor | 125 W Harrison Ave Apt A, Ventura, CA 93001 | 2018-06-11 |
| 1376055012 | Bridge & Temple Inc | Optometrist | 828 E Main Street, Ventura, CA 93001 | 2017-11-03 |
| 1578073763 | Karin Huang | Counselor | 2001, 28th St, Bakerfield, CA 93001 | 2017-10-03 |
| 1487170346 | Stephanie Martello | Counselor | 864 East Santa Clara Street, Ventura, CA 93001 | 2017-08-22 |
| 1477080885 | Isabel Ojeda-cobaruvias | Specialist/Technologist | 1234 E. Main Street, Ventura, CA 93001 | 2017-05-16 |
| 1902219413 | Julio Perez | Specialist/Technologist | 1234 Main St., Ventura, CA 93001 | 2014-06-03 |
| 1417380478 | Lacey Piper | Dietitian, Registered | 2841 Harbor Blvd., Ventura, CA 93001 | 2013-08-14 |
| Find all providers in zip 93001 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952929739 | Christine Yana Barna | Counselor | 641 E Thompson Blvd, Ventura, CA 93001 | 2020-07-08 |
| 1326688979 | Ruby Johnstone | Counselor | 334 W Harrison Ave, Ventura, CA 93001-1826 | 2020-01-12 |
| 1700379096 | Terrence Swanson | Counselor | 125 W Harrison Ave Apt A, Ventura, CA 93001 | 2018-06-11 |
| 1649793308 | Melissa Gerwe | Counselor | 5495 Hollings St, Ventura, CA 93003-2227 | 2017-07-24 |
| 1083074116 | Robert Lightcap | Counselor | 1175 Chalmette Ave, Ventura, CA 93003-5856 | 2016-03-02 |
| 1699165589 | Carlos Antonio Menendez I | Counselor | 536 E Thompson Blvd, Ventura, CA 93001-2841 | 2015-01-29 |
| 1184048860 | Kimberly Andre Fouche | Counselor | 260 Maple Ct Ste 250, Ventura, CA 93003-3571 | 2014-02-14 |
| 1982034096 | Flora Estelle Prouse | Counselor | 5225 Telegraph Rd Fl 2, Ventura, CA 93003-4113 | 2013-11-26 |
| 1619255296 | Julie L. Howard-balmer | Counselor | 3160 Telegraph Rd Ste 103, Ventura, CA 93003-3246 | 2011-07-29 |
| 1669761532 | Ted Wrablik | Counselor | 9050 Feather Street, Ventura, CA 93004 | 2011-03-31 |
| Find all providers in VENTURA | ||||
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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.