1518196146 NPI number — MILLENNIUM HOME CARE SERVICES

Table of content: (NPI 1518196146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518196146 NPI number — MILLENNIUM HOME CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
MILLENNIUM HOME CARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518196146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 445
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVILLE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48112-0445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-320-7625
Provider Business Mailing Address Fax Number:
734-391-7180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7493 KIRKRIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVILLE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48111-1615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-320-7625
Provider Business Practice Location Address Fax Number:
734-391-7180
Provider Enumeration Date:
07/02/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PEATRY-JOHNSON
Authorized Official First Name:
TRENA
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
734-320-7625

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)