Provider Demographics
NPI:1730867193
Name:MILLENNIUM HEALTHCARE LLC
Entity type:Organization
Organization Name:MILLENNIUM HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AFRICA
Authorized Official - Middle Name:N
Authorized Official - Last Name:RELEFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-768-1005
Mailing Address - Street 1:920 W OWENS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-2516
Mailing Address - Country:US
Mailing Address - Phone:702-768-1005
Mailing Address - Fax:
Practice Address - Street 1:920 W OWENS AVE STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-2516
Practice Address - Country:US
Practice Address - Phone:702-659-6910
Practice Address - Fax:702-659-6921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty