Provider Demographics
NPI:1851654974
Name:WE CARE DEVELOPMENTAL MILESTONES
Entity Type:Organization
Organization Name:WE CARE DEVELOPMENTAL MILESTONES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SI/COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON-MUSA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/EI SPECIALIST
Authorized Official - Phone:404-432-0377
Mailing Address - Street 1:5205 VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-5146
Mailing Address - Country:US
Mailing Address - Phone:404-432-0377
Mailing Address - Fax:770-969-6319
Practice Address - Street 1:5205 VILLAGE CT
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-5146
Practice Address - Country:US
Practice Address - Phone:404-432-0377
Practice Address - Fax:770-969-6319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251300000XAgenciesLocal Education Agency (LEA)
No302F00000XManaged Care OrganizationsExclusive Provider Organization