Provider Demographics
NPI:1700819216
Name:MILLER HEALTHCARE LLC
Entity Type:Organization
Organization Name:MILLER HEALTHCARE LLC
Other - Org Name:LAWRENCEVILLE NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:609-896-1494
Mailing Address - Street 1:112 FRANKLIN CORNER RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2104
Mailing Address - Country:US
Mailing Address - Phone:609-896-1494
Mailing Address - Fax:609-896-3627
Practice Address - Street 1:112 FRANKLIN CORNER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2104
Practice Address - Country:US
Practice Address - Phone:609-896-1494
Practice Address - Fax:609-896-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ06114314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315113Medicare ID - Type UnspecifiedMEDICARE ID #