Provider Demographics
NPI:1972860153
Name:MILESTONES ASSISTIVE THERAPY INC.
Entity Type:Organization
Organization Name:MILESTONES ASSISTIVE THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:PIERCE
Authorized Official - Last Name:TIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:248-789-0232
Mailing Address - Street 1:30170 WOODGATE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5379
Mailing Address - Country:US
Mailing Address - Phone:248-789-0232
Mailing Address - Fax:
Practice Address - Street 1:30170 WOODGATE DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5379
Practice Address - Country:US
Practice Address - Phone:248-789-0232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2015-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
MI5201002048252Y00000X, 283XC2000X, 251V00000X, 273Y00000X, 283XC2000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No283XC2000XHospitalsRehabilitation HospitalChildren
No251V00000XAgenciesVoluntary or Charitable
No273Y00000XHospital UnitsRehabilitation Unit