Provider Demographics
NPI:1801239322
Name:MILESTONES BEHAVIORAL HEALTH AGENCY LLC
Entity type:Organization
Organization Name:MILESTONES BEHAVIORAL HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-556-3505
Mailing Address - Street 1:801 S RANCHO DR
Mailing Address - Street 2:SUITE C4
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3854
Mailing Address - Country:US
Mailing Address - Phone:702-556-3505
Mailing Address - Fax:
Practice Address - Street 1:801 S RANCHO DR
Practice Address - Street 2:SUITE C4
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3854
Practice Address - Country:US
Practice Address - Phone:702-556-3505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20131225114103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty