Healthcare Provider Details

I. General information

NPI: 1174457048
Provider Name (Legal Business Name): A STEP FORWARD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18234 N ALICIA CT
MARICOPA AZ
85138-5174
US

IV. Provider business mailing address

833 W DOBBINS RD UNIT A
PHOENIX AZ
85041-8371
US

V. Phone/Fax

Practice location:
  • Phone: 602-461-1974
  • Fax:
Mailing address:
  • Phone: 602-461-1974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NATAYSHA KIELYNN TYLER
Title or Position: MANAGING MEMBER
Credential:
Phone: 602-461-1974