Provider Demographics
NPI:1194862565
Name:MILESTONES AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:MILESTONES AREA AGENCY ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:JAEGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-682-2270
Mailing Address - Street 1:935 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2633
Mailing Address - Country:US
Mailing Address - Phone:641-682-2270
Mailing Address - Fax:641-682-2445
Practice Address - Street 1:117 N COOPER AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-3322
Practice Address - Country:US
Practice Address - Phone:641-682-2270
Practice Address - Fax:641-682-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0107862Medicaid