Healthcare Provider Details

I. General information

NPI: 1427421387
Provider Name (Legal Business Name): A STEP AHEAD HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2015
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 CEDARS OF LEBANON RD
JACKSON MS
39206-3504
US

IV. Provider business mailing address

106 CEDARS OF LEBANON RD
JACKSON MS
39206-3504
US

V. Phone/Fax

Practice location:
  • Phone: 769-257-7448
  • Fax: 888-351-3761
Mailing address:
  • Phone: 769-257-7448
  • Fax: 888-351-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateMS

VIII. Authorized Official

Name: MELODY BURTON
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 769-257-7448