Provider Demographics
NPI:1235278953
Name:MILLENIUM NURSING AGENCY LTD
Entity type:Organization
Organization Name:MILLENIUM NURSING AGENCY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:O
Authorized Official - Last Name:EFEURHOBO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-825-9080
Mailing Address - Street 1:130 TRI COUNTY PKWY STE 215
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3235
Mailing Address - Country:US
Mailing Address - Phone:513-825-9080
Mailing Address - Fax:513-825-1153
Practice Address - Street 1:130 TRI COUNTY PKWY STE 215
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3235
Practice Address - Country:US
Practice Address - Phone:513-825-9080
Practice Address - Fax:513-825-1153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OH200319702630163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1235278953Medicaid