Provider Demographics
NPI:1518196146
Name:MILLENNIUM HOME CARE SERVICES
Entity Type:Organization
Organization Name:MILLENNIUM HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TRENA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:PEATRY-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-320-7625
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48112-0445
Mailing Address - Country:US
Mailing Address - Phone:734-320-7625
Mailing Address - Fax:734-391-7180
Practice Address - Street 1:7493 KIRKRIDGE ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-1615
Practice Address - Country:US
Practice Address - Phone:734-320-7625
Practice Address - Fax:734-391-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care