Provider Demographics
NPI:1336329614
Name:MILESTONES TREATMENT & LEARNING CENTER, INC
Entity type:Organization
Organization Name:MILESTONES TREATMENT & LEARNING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:SOLOMON
Authorized Official - Last Name:CUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MED/CCC
Authorized Official - Phone:336-659-0806
Mailing Address - Street 1:4401 CHERRY ST STE 50
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-2500
Mailing Address - Country:US
Mailing Address - Phone:336-659-0806
Mailing Address - Fax:336-659-1054
Practice Address - Street 1:4401 CHERRY ST STE 50
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-2500
Practice Address - Country:US
Practice Address - Phone:336-659-0806
Practice Address - Fax:336-659-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC829235Z00000X
261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211967Medicaid
NCE2524OtherMEDCOST DR ID
NC694621OtherUNITED HEALTH CARE
NC7426450Medicaid
NC9340223OtherAETNA
NCB1272OtherMEDCOST PRACTICE ID
NC26450OtherBCBS
NC51047116OtherTRICARE PROVIDER NUMBER