MEDICARE: NEXT STEP TRANSITION CENTER 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
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1518391614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXT STEP TRANSITION CENTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 1106
Second Line	:
City	:	DEER PARK
State	:	TX
Zip	:	77536-1106
Country	:	US
Telephone Number	:	832-865-1859
Fax Number	:	832-429-3006

Provider Business Practice Location Address
First Line	:	229 E VAUGHN LN
Second Line	:
City	:	DEER PARK
State	:	TX
Zip	:	77536-4938
Country	:	US
Telephone Number	:	832-865-1859
Fax Number	:	832-429-3006

Authorized Official
Title or Position	:	OWNER
Name	:	TRACI JOHNSTON
Credential	:
Telephone Number	:	832-865-1859

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	11/07/2019

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