Organization
MILLENNIUM LIVING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GABRIELLA MICHELLE PREWITT (LPN)
(248) 770-0310
Entity
Organization
Contact information
Practice address
6031 SILVERBROOK W, WEST BLOOMFIELD, MI 48322-1014
(248) 770-0310
Mailing address
6031 SILVERBROOK W, WEST BLOOMFIELD, MI 48322-1014
(248) 770-0310
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
01/23/2024
Last updated
01/28/2024
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