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General NPI Number Information
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NPI Number | 1205635448
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Entity Type | Organization
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Legal Business Name | STEP BY STEP YOUNG ADULT CENTER
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 17690 NW 78TH AVE STE 104
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City | HIALEAH
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State | FL
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Zip | 33015-3669
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Country | US
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Telephone | 786-367-1304
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Fax | 786-542-0920
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Provider Business Mailing Address
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Address Line | 17601 NW 78TH AVE STE 103
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City | HIALEAH
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State | FL
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Zip | 33015-3650
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Country | US
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Telephone | 786-367-1304
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISELY JIMENEZ
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Credential |
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Telephone | 786-367-1304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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