MEDICARE: NEXT STEP RECOVERY

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	320800000X	Mental Illness Community Based Residential Treatment Facility	10D2068987	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10D2068987	OTHER	FL	CLIA

General Provider Information

NPI Number	:	1649690421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXT STEP RECOVERY

Provider Business Mailing Address
First Line	:	8908 BRIARWOOD MEADOW LN
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33473-7816
Country	:	US
Telephone Number	:	954-560-5238
Fax Number	:	888-510-9071

Provider Business Practice Location Address
First Line	:	2771 HYPOLUXO RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-3826
Country	:	US
Telephone Number	:	954-560-5238
Fax Number	:	888-510-9071

Authorized Official
Title or Position	:	LABORATORY DIRECTOR
Name	:	RALPH HARVEY
Credential	:	CEO
Telephone Number	:	561-843-4877

Provider Enumeration Date	:	04/21/2014
Last Update Date	:	04/21/2014

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Directions to “NEXT STEP RECOVERY ” Practice Location

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