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NPI Code Detail

MEDICARE: MILESTONE HOUSE

MEDICARE: MILESTONE HOUSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility
2261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1568094084
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILESTONE HOUSE
Provider Business Mailing Address
First Line : 1816 PORTOFINO DR
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-6130
Country : US
Telephone Number : 760-433-6361
Fax Number : 760-439-7402
Provider Business Practice Location Address
First Line : 1816 PORTOFINO DR
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-6130
Country : US
Telephone Number : 760-433-6361
Fax Number : 760-439-7402
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : BEVERLY BOONE
Credential :
Telephone Number : 760-433-6361
Provider Enumeration Date : 02/12/2020
Last Update Date : 10/05/2023

Similar Medicare Providers

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1063009884 — BEVERLY BOONE
Practice Location Address:
1816 PORTOFINO DR
OCEANSIDE, CA
92054-6130
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Practice Fax: 760-439-7402
1639755986 — KAYLEIGH COLE MS
Practice Location Address:
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OCEANSIDE, CA
92054-6130
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Practice Fax:
1497335038 — KELLY FAITH LYLES
Practice Location Address:
1816 PORTOFINO DR
OCEANSIDE, CA
92054-6130
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Practice Fax:

Directions to “MILESTONE HOUSE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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