Healthcare Provider Details

I. General information

NPI: 1992791511
Provider Name (Legal Business Name): MILLENNIUM HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18600 W 10 MILE RD SUITE # 104
SOUTHFIELD MI
48075-2645
US

IV. Provider business mailing address

18600 W 10 MILE RD SUITE # 104
SOUTHFIELD MI
48075-2645
US

V. Phone/Fax

Practice location:
  • Phone: 248-569-9303
  • Fax: 248-569-9728
Mailing address:
  • Phone: 248-569-9303
  • Fax: 248-569-9728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number237449
License Number StateMI

VIII. Authorized Official

Name: MR. FARID A KAZI
Title or Position: CEO/PRESIDENT
Credential:
Phone: 248-569-9303