MEDICARE: NEXT STEP COMMUNITY OUTREACH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1215343447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXT STEP COMMUNITY OUTREACH LLC

Provider Business Mailing Address
First Line	:	517 CHALET DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-2909
Country	:	US
Telephone Number	:	205-332-3719
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 BAGBY DR STE 354
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-3735
Country	:	US
Telephone Number	:	205-275-2917
Fax Number	:	844-804-2323

Authorized Official
Title or Position	:	CEO
Name	:	STEPHEN WILEY
Credential	:
Telephone Number	:	205-275-2917

Provider Enumeration Date	:	07/09/2014
Last Update Date	:	07/09/2014

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Directions to “NEXT STEP COMMUNITY OUTREACH LLC ” Practice Location

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