=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114891629
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEXT STEP HEALTHCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2025
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 555 FRANKLIN AVE
-----------------------------------------------------
City | HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06114-3081
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-593-2031
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 555 FRANKLIN AVE
-----------------------------------------------------
City | HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06114-3081
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-593-2031
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | REGINALD L TOLLIVER III
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 860-593-2031
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------