Provider Demographics
NPI:1578797056
Name:MILESTONES FAMILY SERVICES, LLC
Entity type:Organization
Organization Name:MILESTONES FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER/PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-490-6931
Mailing Address - Street 1:849 MAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-3694
Mailing Address - Country:US
Mailing Address - Phone:207-490-6931
Mailing Address - Fax:207-490-4151
Practice Address - Street 1:849 MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-3694
Practice Address - Country:US
Practice Address - Phone:207-490-6931
Practice Address - Fax:207-490-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME406490000Medicaid