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General NPI Number Information
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NPI Number | 1437881042
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Entity Type | Organization
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Legal Business Name | BOLD STEPS OF PA LLC
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 4755 LINGLESTOWN RD STE 402
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City | HARRISBURG
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State | PA
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Zip | 17112-8547
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Country | US
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Telephone | 717-341-6004
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Fax | 717-859-5674
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Provider Business Mailing Address
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Address Line | 1642 63RD ST
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City | BROOKLYN
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State | NY
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Zip | 11204-2744
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Country | US
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Telephone | 718-686-8292
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Fax | 717-859-5674
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Authorized Official
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Title or Position | CEO
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Name | MR. CHAIM BERGER
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Credential |
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Telephone | 718-686-8292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health 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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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