Healthcare Provider Details

I. General information

NPI: 1659275238
Provider Name (Legal Business Name): MILESTONE ABA NC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 N COLE AVE UNIT 312
SPRING VALLEY NY
10977-4740
US

IV. Provider business mailing address

59 N COLE AVE UNIT 312
SPRING VALLEY NY
10977-4740
US

V. Phone/Fax

Practice location:
  • Phone: 718-400-8679
  • Fax:
Mailing address:
  • Phone: 718-400-8679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR HR MANAGER
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 718-400-8679