Healthcare Provider Details

I. General information

NPI: 1487907929
Provider Name (Legal Business Name): STEPS TO YOUR DREAMS FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2012
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6276 PLATTSBURG RD
SOUTH CHARLESTON OH
45368-8801
US

IV. Provider business mailing address

6276 PLATTSBURG RD
SOUTH CHARLESTON OH
45368-8801
US

V. Phone/Fax

Practice location:
  • Phone: 937-717-6741
  • Fax: 937-284-8186
Mailing address:
  • Phone: 937-717-6741
  • Fax: 937-284-8186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMANDA NICOLE SHEARER
Title or Position: PRESIDENT
Credential:
Phone: 937-717-6741