Organization
MILESTONE SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ERICA MOON (CEO)
(602) 402-5946
Entity
Organization
Contact information
Practice address
13581 W YOUNG ST, SURPRISE, AZ 85374-5415
(602) 402-5946
Mailing address
13581 W YOUNG ST, SURPRISE, AZ 85374-5415
(602) 402-5946
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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