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General NPI Number Information
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NPI Number | 1871086520
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Entity Type | Organization
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Legal Business Name | STEP 1 , INC.
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 09/12/2020
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Provider Practice Location Address
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Address Line | 750 E PRIMA VISTA BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-2259
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Country | US
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Telephone | 305-710-1277
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Fax |
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Provider Business Mailing Address
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Address Line | 5944 CORAL RIDGE DR STE 153
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-3300
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Country | US
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Telephone | 305-710-1277
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Fax | 772-325-2355
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Authorized Official
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Title or Position | CE)
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Name | JUSTIN DAVID MORALES
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Credential |
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Telephone | 305-710-1277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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