Provider Demographics
NPI:1790996536
Name:MILLENNIA HEALTHCARE, INC
Entity Type:Organization
Organization Name:MILLENNIA HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOKUNBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-878-0909
Mailing Address - Street 1:21400 INTERNATIONAL BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6086
Mailing Address - Country:US
Mailing Address - Phone:206-878-0909
Mailing Address - Fax:206-878-5259
Practice Address - Street 1:21400 INTERNATIONAL BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98198-6086
Practice Address - Country:US
Practice Address - Phone:206-878-0909
Practice Address - Fax:206-878-5259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-377251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health