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General NPI Number Information
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NPI Number | 1518350875
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Entity Type | Organization
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Legal Business Name | MILLENNIUM HOME CARE LLC
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 564 MAIN ST STE 203
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City | WALTHAM
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State | MA
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Zip | 02452-5559
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Country | US
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Telephone | 617-782-0262
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Fax | 617-254-0464
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Provider Business Mailing Address
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Address Line | 395 WESTERN AVE
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City | BRIGHTON
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State | MA
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Zip | 02135-1005
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Country | US
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Telephone | 617-686-3668
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | RUZAN GASPARYAN
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Credential |
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Telephone | 617-782-0262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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