Organization
MILLENNIUM RESIDENTIAL HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMIADI EDOGI (ADMINISTRATOR)
(623) 418-2266
Entity
Organization
Contact information
Practice address
10325 W SAN JUAN AVE, GLENDALE, AZ 85307-4310
(623) 418-2266
(623) 218-1520
Mailing address
10325 W SAN JUAN AVE, GLENDALE, AZ 85307-4310
(623) 418-2266
(623) 218-1520
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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