Healthcare Provider Details

I. General information

NPI: 1073397311
Provider Name (Legal Business Name): STEP-UP EMPOWERMENT SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21945 THREE NOTCH RD STE 102
LEXINGTON PARK MD
20653-1563
US

IV. Provider business mailing address

21945 THREE NOTCH RD STE 102
LEXINGTON PARK MD
20653-1563
US

V. Phone/Fax

Practice location:
  • Phone: 240-346-4285
  • Fax:
Mailing address:
  • Phone: 240-346-4285
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. NATASHA ABBOTT
Title or Position: OWNER
Credential:
Phone: 240-346-4285