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Organization

MILLENNIAL PERSONAL CARE SERVICE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHERONDA LYNN RUTHERFORD MSW (ALTERNATE ADMINISTRATOR)
(662) 491-8889
Entity
Organization

Contact information

Practice address
1717 SAINT JAMES PL, SUITE 625, HOUSTON, TX 77056-3404
(662) 491-8889
Mailing address
1717 SAINT JAMES PL, SUITE 625, HOUSTON, TX 77056-3404
(662) 491-8889

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
017543
TX

Other

Enumeration date
09/30/2014
Last updated
05/10/2017
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