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General NPI Number Information
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NPI Number | 1245711654
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Entity Type | Organization
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Legal Business Name | STEPS SOUTH LLC
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 107 DEWITT CIRCLE
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City | HATTIESBURG
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State | MS
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Zip | 39402
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Country | US
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Telephone | 702-518-5928
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1163
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City | PRENTISS
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State | MS
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Zip | 39474-1163
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Country | US
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Telephone | 601-640-0555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MAURIO TERRELL MCKELLER
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Credential |
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Telephone | 601-640-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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