Provider Demographics
NPI:1619140936
Name:MILLENIUM HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:MILLENIUM HOME HEALTH AGENCY LLC
Other - Org Name:RESTORING YOUR HEALTH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NUSRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-556-6894
Mailing Address - Street 1:20600 EUREKA RD
Mailing Address - Street 2:SUITE 525
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-5343
Mailing Address - Country:US
Mailing Address - Phone:734-556-6894
Mailing Address - Fax:734-288-3796
Practice Address - Street 1:20600 EUREKA RD
Practice Address - Street 2:SUITE 525
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5343
Practice Address - Country:US
Practice Address - Phone:734-556-6894
Practice Address - Fax:734-288-3796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI239108Medicare Oscar/Certification