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General NPI Number Information
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NPI Number | 1174769335
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Entity Type | Organization
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Legal Business Name | MILLENNIUM HEALTH CARE SERVICES
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 1920 FLORIDA BLVD SUITE F
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-4970
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Country | US
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Telephone | 225-667-7626
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Fax | 225-667-7627
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Provider Business Mailing Address
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Address Line | PO BOX 45301
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City | BATON ROUGE
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State | LA
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Zip | 70895
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Country | US
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Telephone | 225-923-3117
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Fax | 225-923-3118
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Authorized Official
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Title or Position | CEO
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Name | MR. DWAINE JOSEPH WOODS SR.
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Credential | MBA
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Telephone | 225-923-3117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | PCA 15142
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License Number State | LA
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