Provider Demographics
NPI:1124578380
Name:MILESTONES BEHAVIORAL INTERVENTIONS
Entity Type:Organization
Organization Name:MILESTONES BEHAVIORAL INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHANG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:714-595-2834
Mailing Address - Street 1:10174 DURANGO RIVER CT
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5921
Mailing Address - Country:US
Mailing Address - Phone:323-868-8793
Mailing Address - Fax:
Practice Address - Street 1:10174 DURANGO RIVER CT
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5921
Practice Address - Country:US
Practice Address - Phone:323-868-8793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC3918352251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health