Provider Demographics
NPI:1114363033
Name:COMMUNITY MILESTONES
Entity Type:Organization
Organization Name:COMMUNITY MILESTONES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:K
Authorized Official - Last Name:CEASER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-273-4401
Mailing Address - Street 1:PO BOX 2011
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07019-2011
Mailing Address - Country:US
Mailing Address - Phone:973-273-4401
Mailing Address - Fax:973-273-4406
Practice Address - Street 1:60 S FULLERTON AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2632
Practice Address - Country:US
Practice Address - Phone:973-273-4401
Practice Address - Fax:973-273-4406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-18
Last Update Date:2013-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care