MILLER HOLDINGS TAKODA INC. NPI 1972670016

NPI Information

NPI: 1972670016
Provider Name: MILLER HOLDINGS TAKODA, INC.

Doing Business As: TAKODA TRAILS

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
350 KOLB DR
FAIRFIELD, OH
ZIP 45014
Phone: (513) 874-0423
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MILLER HOLDINGS TAKODA, INC. is an intermediate care facility mentally retarded in Fairfield, OH. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. MILLER HOLDINGS TAKODA, INC. NPI is 1972670016. The provider is registered as an organization entity type.
The provider Is Doing Business As Takoda Trails.

The provider's business location address is:

350 KOLB DR
FAIRFIELD, OH
ZIP 45014-357
Phone: (513) 874-0423
Fax: (513) 874-0598

The provider's authorized official is Kurt Miller .
The authorized official title is President and has the following contact phone number (330) 307-6816.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 12/28/2012.

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
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

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
1	0072125	MEDICAID	OHIO

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: 4/28/2024

NPI Synchronization or Removal

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