Provider Demographics
NPI:1518350875
Name:MILLENNIUM HOME CARE LLC
Entity Type:Organization
Organization Name:MILLENNIUM HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:RUZAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-782-0262
Mailing Address - Street 1:395 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-1005
Mailing Address - Country:US
Mailing Address - Phone:617-686-3668
Mailing Address - Fax:
Practice Address - Street 1:564 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-5559
Practice Address - Country:US
Practice Address - Phone:617-782-0262
Practice Address - Fax:617-254-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home