Organization
MILLER'S RESIDENTIAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONNIE KELLEY (OWNER/ ADMINISTRATOR)
(918) 527-7461
Entity
Organization
Contact information
Practice address
203 N GUNTER ST, VINITA, OK 74301-2903
(918) 256-3796
(918) 256-3692
Mailing address
203 N GUNTER ST, VINITA, OK 74301-2903
(918) 256-3796
(819) 256-3692
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
RC-1803
OK
Other
Enumeration date
05/02/2013
Last updated
05/02/2013
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