Provider Demographics
NPI:1992427827
Name:MILLER'S ADULT HOME CARE LLC
Entity type:Organization
Organization Name:MILLER'S ADULT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-660-8649
Mailing Address - Street 1:281 BONNLYN DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4301
Mailing Address - Country:US
Mailing Address - Phone:904-660-8649
Mailing Address - Fax:904-592-7089
Practice Address - Street 1:281 BONNLYN DR
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4301
Practice Address - Country:US
Practice Address - Phone:904-660-8649
Practice Address - Fax:904-592-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility