MEDICARE: MILESTONE DECISIONS, INC.

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
1	315P00000X	Intellectual Disabilities Intermediate Care Facility		ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689701435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILESTONE DECISIONS, INC.

Provider Business Mailing Address
First Line	:	3155 RIVER RD S STE 100
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-9819
Country	:	US
Telephone Number	:	503-362-5235
Fax Number	:	503-585-3267

Provider Business Practice Location Address
First Line	:	2087 LEXINGTON ST
Second Line	:
City	:	MOSCOW
State	:	ID
Zip	:	83843-9552
Country	:	US
Telephone Number	:	208-883-8262
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JASON MCARTHUR
Credential	:
Telephone Number	:	503-362-5235

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	08/22/2020

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Directions to “MILESTONE DECISIONS, INC. ” Practice Location

Language	Start Address	Practice Location

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