Organization
MILLER HOLDINGS BROOKSIDE, INC.
Active
Other names
Brookside
Organization subpart
No
Provider details
NPI number
Authorized official
KURT MILLER (PRESIDENT)
(330) 307-6816
Entity
Organization
Contact information
Practice address
780 SNIDER RD, MASON, OH 45040-1309
(513) 398-1020
(513) 398-5228
Mailing address
2460 ELM RD NE, SUITE 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
—
0072148
—
OH
Enumeration date
11/30/2006
Last updated
12/28/2012
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