NPIMap

Organization Active NPI

Miller Holdings Takoda, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Fairfield, OH
National Provider Identifier
1972670016
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
MILLER HOLDINGS TAKODA, INC.
Practice address
350 Kolb Dr
Fairfield, OH 45014-5357
Phone
(513) 874-0423
Fax
(513) 874-0598
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

350 Kolb Dr
Fairfield, OH 45014-5357

Mailing address

2460 Elm Rd NE
Ste 600
Warren, OH 44483-2900
Phone (330) 307-6816

Other identifiers 1

IdentifierTypeStateIssuer
0072125MedicaidOH

Other names 1

  • Takoda Trails Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Miller Holdings Takoda Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1972670016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 ELM RD NE",
            "address_2": "STE 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": "350 KOLB DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145357",
            "telephone_number": "513-874-0423",
            "fax_number": "513-874-0598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER HOLDINGS TAKODA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-12-28",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072125",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Takoda Trails",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.