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General NPI Number Information
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NPI Number | 1467171900
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Entity Type | Organization
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Legal Business Name | A STEP UP BEHAVIORAL SERVICES LLC
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 540 W IRON AVE STE 218
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City | MESA
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State | AZ
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Zip | 85210-6027
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Country | US
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Telephone | 775-378-8664
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Fax |
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Provider Business Mailing Address
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Address Line | 1641 TOPEKA CIR
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City | SPARKS
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State | NV
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Zip | 89434-8866
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Country | US
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Telephone | 775-378-8664
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE C JOHNSON
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Credential |
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Telephone | 775-378-8664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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