Provider Demographics
NPI:1376974493
Name:AMERICAN MILLENNIUM HOSPICE, INC.
Entity Type:Organization
Organization Name:AMERICAN MILLENNIUM HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPCS
Authorized Official - Prefix:MISS
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:G
Authorized Official - Last Name:VILLON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:323-456-5040
Mailing Address - Street 1:3424 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2263
Mailing Address - Country:US
Mailing Address - Phone:323-456-5040
Mailing Address - Fax:323-456-5066
Practice Address - Street 1:3424 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2263
Practice Address - Country:US
Practice Address - Phone:323-456-5040
Practice Address - Fax:323-456-5066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-30
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based