Organization Active NPI

Millennium Home Health Care LLC

  • Home Health Agency
  • Alexandria, VA
National Provider Identifier
1043640360
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HCO-14982 Issued in VA
Legal business name
MILLENNIUM HOME HEALTH CARE LLC
Practice address
4810 Beauregard St
Suite 325
Alexandria, VA 22312-1709
Phone
(703) 941-8412
NPI assigned
Nov 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Muluembet Fisseha
Title
Administrator
Phone
(703) 862-8447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HCO-14982 VA Primary

Addresses

Primary practice location

4810 Beauregard St
Suite 325
Alexandria, VA 22312-1709

Mailing address

4810 Beauregard St
Suite 325
Alexandria, VA 22312-1709
Phone (703) 941-8412

Other identifiers 3

IdentifierTypeStateIssuer
0171824805MedicaidVA
0171830612MedicaidVA
0171836569MedicaidVA

National Provider Directory

National Provider Directory

Locations

4810 Beauregard St
Ste 325
Alexandria, VA 22312
Phone (703) 941-8412

4200 Evergreen Ln
Ste 312
Annandale, VA 22003

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1043640360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 BEAUREGARD ST",
            "address_2": "SUITE 325",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121709",
            "telephone_number": "703-941-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 BEAUREGARD ST",
            "address_2": "SUITE 325",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121709",
            "telephone_number": "703-941-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "FISSEHA",
        "authorized_official_first_name": "MULUEMBET",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-862-8447",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "HCO-14982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0171824805",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0171830612",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0171836569",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.