MEDICARE: A STEP AWAY

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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1366399081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A STEP AWAY

Provider Business Mailing Address
First Line	:	128 FAIRGROUND CIR APT 502
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-1273
Country	:	US
Telephone Number	:	570-921-9526
Fax Number	:	570-921-9526

Provider Business Practice Location Address
First Line	:	128 FAIRGROUND CIR APT 502
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-1273
Country	:	US
Telephone Number	:	570-921-9526
Fax Number	:	570-921-9526

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	MS. JEHNEL REGINA SMITH
Credential	:	MS
Telephone Number	:	570-921-9526

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “A STEP AWAY ” Practice Location

Language	Start Address	Practice Location

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