Provider Demographics
NPI:1588139919
Name:MILESTONES OF EXCELLENCE LLC
Entity type:Organization
Organization Name:MILESTONES OF EXCELLENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-497-6563
Mailing Address - Street 1:3126 WOODHILL RD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-2290
Mailing Address - Country:US
Mailing Address - Phone:310-497-6563
Mailing Address - Fax:
Practice Address - Street 1:3126 WOODHILL RD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-2290
Practice Address - Country:US
Practice Address - Phone:310-497-6563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities