Provider Demographics
NPI:1811448509
Name:MILLENNIUM COMPANION, INC
Entity type:Organization
Organization Name:MILLENNIUM COMPANION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-414-8698
Mailing Address - Street 1:9700 N RODNEY PARHAM RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-6244
Mailing Address - Country:US
Mailing Address - Phone:501-414-8698
Mailing Address - Fax:501-414-8699
Practice Address - Street 1:9700 N RODNEY PARHAM RD
Practice Address - Street 2:SUITE B
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-6244
Practice Address - Country:US
Practice Address - Phone:501-414-8698
Practice Address - Fax:501-414-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR5190251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health