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General NPI Number Information
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NPI Number | 1396157749
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Entity Type | Organization
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Legal Business Name | A STEP ABOVE COMPANION SERVICES
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 809 GEORGIA AVE
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City | LEESBURG
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State | FL
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Zip | 34748-3744
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Country | US
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Telephone | 407-535-2780
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Fax | 866-942-7888
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Provider Business Mailing Address
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Address Line | PO BOX 3728
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City | COLUMBIA
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State | SC
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Zip | 29230-3728
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Country | US
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Telephone | 803-691-4742
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Fax | 866-942-7888
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. KEVIN E. WIMBERLY
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Credential |
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Telephone | 803-691-4742
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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 | 233543
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License Number State | FL
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