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General NPI Number Information
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NPI Number | 1831889922
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Entity Type | Organization
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Legal Business Name | MILESTONE COMMUNITY WELLNESS, LLC
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 118 MAIN ST STE 200
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City | STERLING
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State | CO
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Zip | 80751-4358
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Country | US
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Telephone | 720-927-7383
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Fax |
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Provider Business Mailing Address
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Address Line | 118 MAIN ST STE 200
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City | STERLING
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State | CO
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Zip | 80751-4358
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Country | US
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Telephone | 720-927-7383
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | REBECCA STIEB
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Credential | MA, LPCC
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Telephone | 720-927-7383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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