Organization
MARTHA GAIL MILLER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA GAIL MILLER (SOLE PROPRIETOR/PROGRAM MANAGER)
(903) 288-3583
Entity
Organization
Contact information
Practice address
16103 SAINT PAUL DR, MALAKOFF, TX 75148-4370
(903) 288-3583
(903) 489-1814
Mailing address
16103 SAINT PAUL DR, MALAKOFF, TX 75148-4370
(903) 288-3583
(903) 489-1814
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
320900000
TX
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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