Healthcare Provider Details

I. General information

NPI: 1659128072
Provider Name (Legal Business Name): SHEILA MILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

753 WASHINGTON ST STE 5
STOUGHTON MA
02072-2980
US

IV. Provider business mailing address

753 WASHINGTON ST STE 5
STOUGHTON MA
02072-2981
US

V. Phone/Fax

Practice location:
  • Phone: 833-747-3268
  • Fax: 617-927-9487
Mailing address:
  • Phone: 833-747-3268
  • Fax: 617-927-9487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: