Provider Demographics
NPI:1972942407
Name:CHILDREN'S DEVELOPMENTAL MILESTONES
Entity Type:Organization
Organization Name:CHILDREN'S DEVELOPMENTAL MILESTONES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOLIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-203-5067
Mailing Address - Street 1:21241 VENTURA BLVD
Mailing Address - Street 2:SUITE 187
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2108
Mailing Address - Country:US
Mailing Address - Phone:818-203-5063
Mailing Address - Fax:
Practice Address - Street 1:21241 VENTURA BLVD
Practice Address - Street 2:SUITE 187
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2108
Practice Address - Country:US
Practice Address - Phone:818-203-5063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty