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General NPI Number Information
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NPI Number | 1821534157
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Entity Type | Organization
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Legal Business Name | MILLER GROUP HOME INC
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 654 HULSES CORNER RD
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City | HOWELL
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State | NJ
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Zip | 07731-8550
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Country | US
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Telephone | 732-886-3239
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 112
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City | FARMINGDALE
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State | NJ
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Zip | 07727-0112
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Country | US
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Telephone | 732-938-4376
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Fax | 732-938-9472
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CLAIR MILLER
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Credential |
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Telephone | 732-938-4376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number | GH749
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License Number State | NJ
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