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General NPI Number Information
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NPI Number | 1033448246
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Entity Type | Organization
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Legal Business Name | S.T.E.P.S. DEVELOPMENT CENTER, LLC
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 507 E MAIN ST SUITE E.
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-4497
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Country | US
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Telephone | 252-326-0090
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Fax | 252-536-2322
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Provider Business Mailing Address
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Address Line | 289 WADE RD
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City | SCOTLAND NECK
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State | NC
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Zip | 27874-8957
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Country | US
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Telephone | 252-326-0090
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Fax | 252-536-2322
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. WILLIE JAMES GILCHRIST
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Credential | ED D
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Telephone | 252-326-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL-070-047
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License Number State | NC
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