Healthcare Provider Details

I. General information

NPI: 1649418997
Provider Name (Legal Business Name): STEP-BY-STEP SUCCESS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2009
Last Update Date: 01/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 SE 30TH CT
OCALA FL
34480-8421
US

IV. Provider business mailing address

5010 SE 30TH CT
OCALA FL
34480-8421
US

V. Phone/Fax

Practice location:
  • Phone: 352-425-0385
  • Fax: 352-867-1557
Mailing address:
  • Phone: 352-425-0385
  • Fax: 352-867-1557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: SHANNON RENEE GUNTER
Title or Position: OWNER
Credential: BCABA
Phone: 352-425-0385