NPIMap

Organization Active NPI

Milestones of Development, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Vallejo, CA
National Provider Identifier
1427266329
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
LTC60049G Issued in CA
Legal business name
MILESTONES OF DEVELOPMENT, INC.
Practice address
200 Lytham Way
Vallejo, CA 94591-4317
Phone
(707) 644-0496
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cynthia Mack
Title
Administrator
Phone
(707) 644-0496

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X LTC60049G CA Primary

Addresses

Primary practice location

200 Lytham Way
Vallejo, CA 94591-4317

Mailing address

1 Florida St
Vallejo, CA 94590-5000

Other identifiers 2

IdentifierTypeStateIssuer
7005713OtherCAEDS PIN NUMBER
LTC60049GOtherCAPROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G092

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MILESTONES OF DEVELOPMENT #5
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
May 4, 1983
Last certification
Mar 25, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
200 Lytham
Vallejo, CA 94591

National Provider Directory

National Provider Directory
Tax ID family
Milestones of Development Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427266329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FLORIDA ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LYTHAM WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945914317",
            "telephone_number": "707-644-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONES OF DEVELOPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-644-0496"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "LTC60049G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDS PIN NUMBER",
            "identifier": "7005713",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "LTC60049G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.