Provider Demographics
NPI:1184246621
Name:ACHIEVING MILESTONES PEDIATRIC THERAPY, INC
Entity type:Organization
Organization Name:ACHIEVING MILESTONES PEDIATRIC THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDIT
Authorized Official - Middle Name:KATHY
Authorized Official - Last Name:KESHISHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:818-288-3334
Mailing Address - Street 1:1018 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3424
Mailing Address - Country:US
Mailing Address - Phone:818-288-3334
Mailing Address - Fax:
Practice Address - Street 1:221 E GLENOAKS BLVD # 225A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-2085
Practice Address - Country:US
Practice Address - Phone:818-288-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty