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General NPI Number Information
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NPI Number | 1043628522
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Entity Type | Organization
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Legal Business Name | LIFE STEPS, LLC
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 901 N CONGRESS AVE SUITE B102
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3316
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Country | US
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Telephone | 888-357-8377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4682
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City | BOYNTON BEACH
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State | FL
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Zip | 33424-4682
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Country | US
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Telephone | 954-232-7290
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ADAM M FULLER
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Credential |
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Telephone | 954-232-7290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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