| Organization Name: | MILLENNIUM MEDICAL SERVICES, LLC |
| NPI Number: | 1013348846 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WADE HAMIL (CEO) |
| Mailing Address: | 221 W 3rd St Hobart |
| State: | OK US |
| Postal Code: | 736513603 |
| Phone Number: | 8885737792 |
| Fax Number: | 8887538162 |
| NPI Enumeration Date: | 12/04/2013 |
| NPI Last Update Date: | 12/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 785 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |