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TRACEY NICOLE MILLER

Assisted Living, Mental Illness

Avondale, Arizona

Provider NPI: 1457406589

Organization Information:
Organization Name:  TRACEY NICOLE MILLER


Practice Location:
12641 W MERRELL ST  AVONDALE, AZ 85323 US
Tel: 623-535-5565  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3104A0625XNursing & Custodial Care Facilities
Assisted Living Facility
Assisted Living, Mental Illness
AZBH2685

Other Provider Identifiers:

IssuerNumberStateType
139650AZ05
STATE LICENSEBH2685AZ01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTAL ILLNESS JOBS AZ - Page 1