Organization
MILLENNIAL HEALTHCARE, LLC
Active
Other names
Millennial Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE JAQUETTA NICOLE BUCKNER (OWNER)
(601) 882-4878
Entity
Organization
Contact information
Practice address
5290 GALAXIE DR STE 105, JACKSON, MS 39206-4311
(601) 882-4878
Mailing address
655 MEADOWBROOK RD, JACKSON, MS 39206-5842
(601) 882-4878
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
03/22/2023
Last updated
10/20/2023
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