TRACEY NICOLE MILLER NPI 1457406589

NPI Information

  • NPI: 1457406589
  • Provider Name: TRACEY NICOLE MILLER
  • Classification: Assisted Living Facility - 3104A0625X
  • Specialization: Assisted Living, Mental Illness
  • Entity Type: Organization
  • Address: 12641 W MERRELL ST
    AVONDALE, AZ
    ZIP 85323
  • Phone: (623) 535-5565

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NPI Details

TRACEY NICOLE MILLER is an assisted living and mental illness assisted living facility in Avondale, AZ. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. TRACEY NICOLE MILLER NPI is 1457406589. The provider is registered as an organization entity type.

The provider's business location address is:

12641 W MERRELL ST
AVONDALE, AZ
ZIP 85323-629
Phone: (623) 535-5565

The provider's authorized official is Tracey Nicole Miller .
The authorized official title is Administrator and has the following contact phone number (623) 535-5565.

The enumeration date for this NPI number is 1/25/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessBH2685ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1139650MEDICAIDARIZONA
2BH2685OTHERARIZONASTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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