=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750512737
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILESTONE SOCIAL SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2009
-----------------------------------------------------
Last Update Date | 08/07/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5324 PINEVIEW WAY
-----------------------------------------------------
City | APOPKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32703-1963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-295-3191
-----------------------------------------------------
Fax | 407-218-8829
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5324 PINEVIEW WAY
-----------------------------------------------------
City | APOPKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32703-1963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-295-3191
-----------------------------------------------------
Fax | 407-218-8829
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT & CEO
-----------------------------------------------------
Name | MS. DORIS DUAN-YOUNG
-----------------------------------------------------
Credential | M.S., BCBA
-----------------------------------------------------
Telephone | 407-295-3191
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253J00000X
-----------------------------------------------------
Taxonomy Name | Foster Care Agency
-----------------------------------------------------
License Number | 18-3742-006-08
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------