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Organization

D MILLER INNOVATIVE CARE INC

Active
Other names
Crawford County Convalescent Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DWIGHT L MILLER (ADMINISTRATOR OWNER)
(618) 546-5638
Entity
Organization

Contact information

Practice address
902 W MEFFORD STREET, ROBINSON, IL 62454
(618) 546-5638
(618) 544-7068
Mailing address
PO BOX 192, 902 W MEFFORD STREET, ROBINSON, IL 62454
(618) 546-5638
(618) 544-7068

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0029645
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0662232
IL
Enumeration date
10/12/2006
Last updated
08/22/2020
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