Healthcare Provider Details

I. General information

NPI: 1710992573
Provider Name (Legal Business Name): POSITIVE STEP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E GRANVILLE ST
WINDSOR NC
27983-6752
US

IV. Provider business mailing address

102 E GRANVILLE ST
WINDSOR NC
27983-6752
US

V. Phone/Fax

Practice location:
  • Phone: 252-794-2561
  • Fax: 252-794-2558
Mailing address:
  • Phone: 252-794-2561
  • Fax: 252-794-2558

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 Code376J00000X
TaxonomyHomemaker
License NumberHC2242
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberHC2242
License Number StateNC

VIII. Authorized Official

Name: DELTHEMA ALLEN
Title or Position: ADMINISTRATOR
Credential:
Phone: 252-794-2561