Provider Demographics
NPI:1376556571
Name:MILLENNIUM INSTITUTE FOR ADVANCE NURSING CARE INC
Entity Type:Organization
Organization Name:MILLENNIUM INSTITUTE FOR ADVANCE NURSING CARE INC
Other - Org Name:THE MILLENNIUM INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECITUVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:VILAR
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-708-0138
Mailing Address - Street 1:100 GRAND PASEO BLVD
Mailing Address - Street 2:STE 112 MSC 404
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5905
Mailing Address - Country:US
Mailing Address - Phone:787-708-0138
Mailing Address - Fax:787-720-6072
Practice Address - Street 1:CALLE COSME REPARTO SAN LIUCAS
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926-5955
Practice Address - Country:US
Practice Address - Phone:787-708-0138
Practice Address - Fax:787-720-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRLIC 5 CNC -01-044314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR405028Medicare Oscar/Certification