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General NPI Number Information
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NPI Number | 1275374019
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Entity Type | Organization
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Legal Business Name | NEXT STEP FORWARD COMMUNITY DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 2710 COLLEGE AVE LOWER LEVEL (LL-1)
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City | ALTON
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State | IL
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Zip | 62002
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Country | US
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Telephone | 618-433-1008
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Fax | 618-433-1008
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Provider Business Mailing Address
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Address Line | 2710 COLLEGE AVE LOWER LEVEL (LL-1)
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City | ALTON
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State | IL
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Zip | 62002
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Country | US
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Telephone | 618-433-1008
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Fax | 618-433-1008
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DARLENE CROFT
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Credential | CNA
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Telephone | 618-433-1008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care 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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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