Provider Demographics
NPI:1003221664
Name:MILLER MEMORIAL CARE CENTER, LLC
Entity Type:Organization
Organization Name:MILLER MEMORIAL CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ASCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-874-2292
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:CHAPPELL
Mailing Address - State:NE
Mailing Address - Zip Code:69129-0428
Mailing Address - Country:US
Mailing Address - Phone:308-874-2292
Mailing Address - Fax:308-874-2294
Practice Address - Street 1:589 VINCENT AVE
Practice Address - Street 2:
Practice Address - City:CHAPPELL
Practice Address - State:NE
Practice Address - Zip Code:69129-9708
Practice Address - Country:US
Practice Address - Phone:308-874-2292
Practice Address - Fax:308-874-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility