- Enrollment id
- O20090219000248
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1144468992
- Multiple npi flag
- N
- Ccn
- 059285
- Associate id
- 3779648191
- Organization name
- MILLENNIUM HOME HEALTH CARE, INC.
- Incorporation date
- 2009-01-09
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 13758 VICTORY BLVD
- Address line 2
- STE 208
- City
- VAN NUYS
- State
- CA
- Zip code
- 914016734