Provider Demographics
NPI:1720481559
Name:MILESTONES PEDIATRIC THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:MILESTONES PEDIATRIC THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-232-5922
Mailing Address - Street 1:58 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6912
Mailing Address - Country:US
Mailing Address - Phone:603-232-5922
Mailing Address - Fax:
Practice Address - Street 1:58 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6912
Practice Address - Country:US
Practice Address - Phone:603-232-5922
Practice Address - Fax:603-232-3714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty