Healthcare Provider Details

I. General information

NPI: 1497503148
Provider Name (Legal Business Name): MILLENNIUM ADULT DAY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 N RODNEY PARHAM RD STE B
LITTLE ROCK AR
72227-6252
US

IV. Provider business mailing address

9700 N RODNEY PARHAM RD STE B
LITTLE ROCK AR
72227-6252
US

V. Phone/Fax

Practice location:
  • Phone: 501-414-8698
  • Fax: 501-414-8699
Mailing address:
  • Phone: 501-414-8698
  • Fax: 501-414-8699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHAY STEVENS
Title or Position: PRESIDENT
Credential:
Phone: 501-414-8698