Provider Demographics
NPI:1669989273
Name:MILLS, OTIS & ASSOCIATES LLC
Entity type:Organization
Organization Name:MILLS, OTIS & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ FACILIATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAWAN
Authorized Official - Middle Name:ALISA
Authorized Official - Last Name:SILVER-MANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-343-4479
Mailing Address - Street 1:1680 BRIARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-3666
Mailing Address - Country:US
Mailing Address - Phone:757-343-4479
Mailing Address - Fax:
Practice Address - Street 1:1680 BRIARFIELD RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-3666
Practice Address - Country:US
Practice Address - Phone:757-343-4479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care