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General NPI Number Information
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NPI Number | 1790226306
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Entity Type | Organization
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Legal Business Name | MILESTONE BEHAVIORAL HEALTH SYSTEMS LLC
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 7697 COLONY LAKE DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33436
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Country | US
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Telephone | 305-497-3895
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Fax |
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Provider Business Mailing Address
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Address Line | 7697 COLONY LAKE DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33436
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASMINE WRIGHT
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Credential | LCSW
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Telephone | 305-497-3895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW14071
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License Number State | FL
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