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Organization
MILLER HOLDINGS TAKODA, INC.
Active
Organization
MILLER HOLDINGS TAKODA, INC.
Active
Other names
John Gray Home
Organization subpart
No
Provider details
NPI number
Authorized official
KURT MILLER (PRESIDENT)
(330) 307-6816
Entity
Organization
Contact information
Practice address
2049 JOHN GRAY ROAD, CINCINNATI, OH 45240
(513) 674-0384
(513) 674-0464
Mailing address
2460 ELM RD NE, STE 600, WARREN, OH 44483-2900
(330) 307-6816
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072244
—
OH
Enumeration date
06/23/2010
Last updated
12/28/2012
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