MEDICARE: JANAYA MCMILLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	400686441107	OH

General Provider Information

NPI Number	:	1457772659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANAYA MCMILLER

Provider Business Mailing Address
First Line	:	3427 E 126TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-4421
Country	:	US
Telephone Number	:	216-561-0459
Fax Number	:

Provider Business Practice Location Address
First Line	:	3427 E 126TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-4421
Country	:	US
Telephone Number	:	216-561-0459
Fax Number	:

Authorized Official
Title or Position	:	STNA
Name	:	JANAYA ALYSIA MCMILLER
Credential	:
Telephone Number	:	216-561-0459

Provider Enumeration Date	:	12/16/2013
Last Update Date	:	12/16/2013

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