Miller Holdings Manor, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

MILLER HOLDINGS MANOR, INC.

Doing business as

Manor Home

Practice address

246 N Broadway
Geneva, OH 44041-1116

Phone

(440) 466-1808

Fax

(440) 466-1034

NPI assigned

Nov 30, 2006

Last updated

Feb 5, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kurt Miller

Title

President

Phone

(330) 307-6816

Specialties & licenses 1

Addresses

Other names 1

• Manor Home Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437226586. Details of each certification follow.

• CCN 36G005 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G005

Legal name

MANOR HOME

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Oct 1, 1982

Last certification

Mar 21, 2024

Beds

40

Ownership / control type

Private (proprietary)

Facility address

246 N Broadway
Geneva, OH 44041

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rajesh Agarwal, M.D.

  • Specialist
  • Mayfield Heights, OH
  • NPI 1285618579
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1437226586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 ELM RD NE",
            "address_2": "SUITE 600",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444832900",
            "telephone_number": "330-307-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 N BROADWAY",
            "city": "GENEVA",
            "state": "OH",
            "postal_code": "440411116",
            "telephone_number": "440-466-1808",
            "fax_number": "440-466-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER HOLDINGS MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-307-6816"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manor Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beth Mendez, COTA/L
• Susan H Meyer, RD, LD, CDE
• Michael Miadzielec, CNP, PMHNP-BC
• Rebecca Grace Mihic, APRN, CNP
• Yasser Mikhail, MD
• Britney Lynn Miller, M.A., CF-SLP
• Gianna Christine Minnick, PA-C
• Kayla Christine Montgomery, PA-C
• Rachel D Moyers, RN
• Kathleen M Mulhall, LPN

• Intellectual Disabilities Intermediate Care Facility in Geneva, OH
• Providers in Geneva, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.