# MILENIA IDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952824633
- **Authorized official:** ROBERT KOLMAN (MANAGING MEMBER)
- **Authorized official phone:** (516) 537-4913

## Contact information

- **Practice address:** 1510 CHESTER PIKE, EDDYSTONE, PA 19022-1375
- **Practice address phone:** (516) 537-4913
- **Practice address fax:** (516) 537-4910
- **Mailing address:** PO BOX 453, WOODBURY, NY 11797-0453
- **Mailing address phone:** (516) 537-4913
- **Mailing address fax:** (516) 537-4910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 07/25/2017
- **Last updated:** 07/25/2017