Provider Demographics
NPI:1679871107
Name:MILLARRICH,LLC
Entity Type:Organization
Organization Name:MILLARRICH,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:615-945-2113
Mailing Address - Street 1:5022 OLD HYDES FERRY PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-3911
Mailing Address - Country:US
Mailing Address - Phone:615-564-7177
Mailing Address - Fax:888-800-7610
Practice Address - Street 1:5022 OLD HYDES FERRY PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-3911
Practice Address - Country:US
Practice Address - Phone:615-564-7177
Practice Address - Fax:888-800-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
TNL000000007090320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Yes253Z00000XAgenciesIn Home Supportive Care