Provider Demographics
NPI:1386643161
Name:MILLENNIA HEALTHCARE CORP.
Entity Type:Organization
Organization Name:MILLENNIA HEALTHCARE CORP.
Other - Org Name:MILLENNIA HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-381-8310
Mailing Address - Street 1:3731 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2823
Mailing Address - Country:US
Mailing Address - Phone:213-381-8310
Mailing Address - Fax:213-381-8311
Practice Address - Street 1:3731 WILSHIRE BLVD
Practice Address - Street 2:STE 516
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010
Practice Address - Country:US
Practice Address - Phone:213-381-8310
Practice Address - Fax:213-381-8311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058067Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER NUMB