Provider Demographics
NPI:1962029694
Name:DEVELOPMENTAL MILESTONES ADULT DAY CENTER
Entity Type:Organization
Organization Name:DEVELOPMENTAL MILESTONES ADULT DAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNAY
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-406-1115
Mailing Address - Street 1:700 N MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-3150
Mailing Address - Country:US
Mailing Address - Phone:870-400-8937
Mailing Address - Fax:870-733-0561
Practice Address - Street 1:700 N MISSOURI ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-3150
Practice Address - Country:US
Practice Address - Phone:870-400-8923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities