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NPI Code Detail

MEDICARE: STEPPIN OUT FAMILY SERVICES LLC.,

MEDICARE: STEPPIN OUT FAMILY SERVICES LLC.,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training AgencyNV
2253J00000XFoster Care AgencyNV
3251S00000XCommunity/Behavioral Health AgencyNV

General Provider Information

NPI Number : 1306156682
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEPPIN OUT FAMILY SERVICES LLC.,
Provider Business Mailing Address
First Line : 3624 RUSSIAN OLIVE STREET
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032
Country : US
Telephone Number : 702-353-1079
Fax Number :
Provider Business Practice Location Address
First Line : 3624 RUSSIAN OLIVE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7643
Country : US
Telephone Number : 702-353-1079
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MISS LINDA FAY CRUTCHER-AUSTIN
Credential :
Telephone Number : 702-353-1079
Provider Enumeration Date : 10/20/2010
Last Update Date : 10/20/2010

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Directions to “STEPPIN OUT FAMILY SERVICES LLC., ” Practice Location

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