Provider Demographics
NPI:1023893633
Name:KIDS MILESTONE BEHAVIOR THERAPY, LLC
Entity type:Organization
Organization Name:KIDS MILESTONE BEHAVIOR THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISSET
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-600-4388
Mailing Address - Street 1:100 NE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4581
Mailing Address - Country:US
Mailing Address - Phone:786-600-4388
Mailing Address - Fax:
Practice Address - Street 1:100 NE 15TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4581
Practice Address - Country:US
Practice Address - Phone:786-600-4388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POSITIVE INSIGHTS BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-30
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty