Provider Demographics
NPI:1932172707
Name:MILLENNIUM HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:MILLENNIUM HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:INEZ
Authorized Official - Middle Name:C
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-737-1545
Mailing Address - Street 1:2403 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3709
Mailing Address - Country:US
Mailing Address - Phone:210-737-1545
Mailing Address - Fax:210-736-5296
Practice Address - Street 1:2403 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-3709
Practice Address - Country:US
Practice Address - Phone:210-737-1545
Practice Address - Fax:210-736-5296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005269251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000HH9533OtherBCBS
TX024339601Medicaid
459299Medicare Oscar/Certification