Provider Demographics
NPI:1336860428
Name:MILESTONE HEALTH PARTNERS, LLC
Entity type:Organization
Organization Name:MILESTONE HEALTH PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-770-2734
Mailing Address - Street 1:1905 14TH ST W
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-6020
Mailing Address - Country:US
Mailing Address - Phone:701-770-2734
Mailing Address - Fax:701-516-8462
Practice Address - Street 1:1905 14TH ST W
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-6020
Practice Address - Country:US
Practice Address - Phone:701-770-2734
Practice Address - Fax:701-516-8462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty