Healthcare Provider Details

I. General information

NPI: 1508480500
Provider Name (Legal Business Name): ONE STEP BEYOND, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9299 W OLIVE AVE STE 311
PEORIA AZ
85345-8381
US

IV. Provider business mailing address

9299 W OLIVE AVE STE 311
PEORIA AZ
85345-8381
US

V. Phone/Fax

Practice location:
  • Phone: 623-205-9245
  • Fax:
Mailing address:
  • Phone: 623-205-9245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL JOHN HOMCO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 623-205-9245