Healthcare Provider Details

I. General information

NPI: 1124309331
Provider Name (Legal Business Name): MILESTONES SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 04/25/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9113 LEESGATE RD
LOUISVILLE KY
40222
US

IV. Provider business mailing address

9113 LEESGATE RD
LOUISVILLE KY
40222
US

V. Phone/Fax

Practice location:
  • Phone: 502-500-4345
  • Fax: 502-614-7161
Mailing address:
  • Phone: 502-500-4345
  • Fax: 502-614-7161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. ADONNA L WICKLIFFE
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential:
Phone: 502-500-4345