Provider Demographics
NPI:1760044754
Name:MILESTONE RECOVERY, LLC
Entity Type:Organization
Organization Name:MILESTONE RECOVERY, LLC
Other - Org Name:MILESTONE RECOVERY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WHITLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-334-7441
Mailing Address - Street 1:1805 MARTIN LUTHER KING JR DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-4517
Mailing Address - Country:US
Mailing Address - Phone:318-334-7441
Mailing Address - Fax:
Practice Address - Street 1:1805 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-4517
Practice Address - Country:US
Practice Address - Phone:318-334-7441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility