Provider Demographics
NPI:1881013753
Name:PERSONAL MILESTONES, INC
Entity Type:Organization
Organization Name:PERSONAL MILESTONES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOLIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-203-5063
Mailing Address - Street 1:21241 VENTURA BLVD STE 187
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2196
Mailing Address - Country:US
Mailing Address - Phone:818-203-5063
Mailing Address - Fax:805-617-1725
Practice Address - Street 1:21241 VENTURA BLVD STE 187
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2196
Practice Address - Country:US
Practice Address - Phone:818-203-5063
Practice Address - Fax:805-617-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-12-12522103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty