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Tracey Nicole Miller
Assisted Living Facility (Mental Illness) in Avondale, Arizona
NPI 1457406589

Tracey Nicole Miller is an Assisted Living Facility (Mental Illness) based in Avondale, AZ and is specialized in Assisted Living, Mental Illness. Tracey Nicole Miller practices in Avondale, AZ. The NPI Number for Tracey Nicole Miller is 1457406589 and holds a License No. BH2685 (Arizona).

The current practice location address for Tracey Nicole Miller is 12641 W Merrell St, Avondale, AZ and can be reached out via phone at 623-535-5565. You can also correspond with Tracey Nicole Miller through the mailing address at 12641 W MERRELL ST, AVONDALE, AZ - 85323-6629 (mailing address contact number: ).

Location: 12641 W Merrell St, Avondale, AZ, 85323-6629
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1457406589
Provider Name
Tracey Nicole Miller
Credential
Provider Entity Type
Organization
Address
12641 W Merrell St, Avondale, AZ, 85323-6629
Phone Number
623-535-5565
Fax Number
Provider Enumeration Date
01/25/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
BH2685 01 AZ STATE LICENSE
139650 05 AZ
institution
Provider Business Practice Location Address Details
Address
12641 W Merrell St
City
Avondale
State
Arizona
Zip
85323-6629
Phone Number
623-535-5565
Fax Number
person
Provider Business Mailing Address Details
Address
12641 W Merrell St
City
Avondale
State
Arizona
Zip
85323-6629
Phone Number
623-535-5565
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
Assisted Living, Mental Illness
Taxonomy
3104A0625X
License No.
BH2685 (Arizona)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
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