=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487919684
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEP DOWN INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2012
-----------------------------------------------------
Last Update Date | 04/04/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 750 S. MILITARY TRAIL SUITE M
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-766-1639
-----------------------------------------------------
Fax | 561-766-1932
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 750 S. MILITARY TRAIL SUITE M
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-766-1639
-----------------------------------------------------
Fax | 561-766-1932
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | MRS. MELISSA F THOMAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-255-7643
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0405X
-----------------------------------------------------
Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
-----------------------------------------------------
License Number | 1550AD599901
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------