MEDICARE: STEPS FORWARD, L.L.C.

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1518436484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPS FORWARD, L.L.C.

Provider Business Mailing Address
First Line	:	4555 KAREN AVE APT 84
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7699
Country	:	US
Telephone Number	:	602-481-1669
Fax Number	:

Provider Business Practice Location Address
First Line	:	4555 KAREN AVE APT 84
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7699
Country	:	US
Telephone Number	:	602-481-1669
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	CHIVONNE STEPHENS
Credential	:
Telephone Number	:	602-481-1669

Provider Enumeration Date	:	11/20/2018
Last Update Date	:	11/20/2018

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Directions to “STEPS FORWARD, L.L.C. ” Practice Location

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