Millernairclub, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

MILLERNAIRCLUB, LLC

Practice address

100 Carriage House Dr
Suffolk, VA 23434-9219

Phone

(252) 370-5964

NPI assigned

Sep 27, 2021

Organization subpart

No

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

Authorized official

Name

Sakara Dominique Ricks

Title

Ceo

Phone

(252) 370-5964

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1497426613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CARRIAGE HOUSE DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234349219",
            "telephone_number": "252-370-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARRIAGE HOUSE DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234349219",
            "telephone_number": "252-370-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLERNAIRCLUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "SAKARA",
        "authorized_official_middle_name": "DOMINIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-370-5964"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Millernaireclub.org",
            "affiliation": "N",
            "address_1": "100 Carriage House Dr",
            "city": "Suffolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234349219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cassandra A. Miller, PT, DPT, OCS
• Karl Miller, LCSWA
• Melissa Olivia Miller, ATS
• Monica Maria Miller
• Norashawnda Miller, CSAC-A, ICADC
• Diane Milteer
• Sandra R Milteer
• Amjad Minhas, MD
• Sajeel Qayum Mirza, M.D.
• Anne Marie Mishkofski, P.A.

• Mental Illness Community Based Residential Treatment Facility in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Mental Illness Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.