Healthcare Provider Details

I. General information

NPI: 1316563000
Provider Name (Legal Business Name): MILESTONES BEHAVIORAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2020
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W POINTE DR STE D
SWANSEA IL
62226-8310
US

IV. Provider business mailing address

209 W POINTE DR STE D
SWANSEA IL
62226-8310
US

V. Phone/Fax

Practice location:
  • Phone: 618-795-7994
  • Fax:
Mailing address:
  • Phone: 618-795-7994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATASCHA R JEFFRIES
Title or Position: OWNER, NURSE PRACTITIONER
Credential: FNP, PMHNP
Phone: 502-544-9450