Provider Demographics
NPI:1154667780
Name:MILESTONES ALTERNATIVE FAMILY LIVING INC.
Entity type:Organization
Organization Name:MILESTONES ALTERNATIVE FAMILY LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QP/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TARSHA
Authorized Official - Middle Name:TARIA
Authorized Official - Last Name:PURVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSCS
Authorized Official - Phone:252-402-9023
Mailing Address - Street 1:101 HODGES RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3913
Mailing Address - Country:US
Mailing Address - Phone:252-402-9023
Mailing Address - Fax:252-523-8332
Practice Address - Street 1:506 LAROQUE AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4128
Practice Address - Country:US
Practice Address - Phone:252-402-9023
Practice Address - Fax:252-523-8332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health