Healthcare Provider Details

I. General information

NPI: 1194525741
Provider Name (Legal Business Name): NEXT STEP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 6TH AVE S
SAINT CLOUD MN
56301-5377
US

IV. Provider business mailing address

1502 GARFIELD CT
SAINT CLOUD MN
56301-4150
US

V. Phone/Fax

Practice location:
  • Phone: 612-261-6769
  • Fax:
Mailing address:
  • Phone: 612-261-6769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: JASON MARVIN BELLAMY
Title or Position: OWNER
Credential:
Phone: 612-261-6769