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General NPI Number Information
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NPI Number | 1710603162
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Entity Type | Organization
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Legal Business Name | JUST A STEP ABOVE LLC
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 33870 BLUE STAR HWY APT 406
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City | MIDWAY
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State | FL
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Zip | 32343-2432
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Country | US
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Telephone | 757-897-2562
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Fax | 850-765-4013
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Provider Business Mailing Address
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Address Line | 33870 BLUE STAR HWY APT 406
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City | MIDWAY
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State | FL
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Zip | 32343-2432
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Country | US
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Telephone | 757-897-2562
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Fax | 850-765-4013
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Authorized Official
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Title or Position | OWNER
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Name | SHENEKE RENA GLENN
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Credential |
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Telephone | 757-897-2562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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