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General NPI Number Information
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NPI Number | 1497991905
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Entity Type | Organization
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Legal Business Name | MILESTONE THERAPEUTIC CARE RESIDENTIAL SRVCS,INC-CARY
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 103 DOWELL DR
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City | CARY
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State | NC
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Zip | 27511-3825
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Country | US
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Telephone | 919-271-2879
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Fax |
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Provider Business Mailing Address
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Address Line | 505 BELLEFONT CT
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City | KNIGHTDALE
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State | NC
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Zip | 27545-8797
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Country | US
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Telephone | 919-271-2879
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. CURTIS L SPELLER
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Credential |
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Telephone | 919-271-2879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-092-707
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License Number State | NC
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