MEDICARE: STEP ZERO RECOVERY 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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1871470088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEP ZERO RECOVERY SERVICES, LLC

Provider Business Mailing Address
First Line	:	5305 PISTOLERO PL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-8086
Country	:	US
Telephone Number	:	575-993-3504
Fax Number	:

Provider Business Practice Location Address
First Line	:	5305 PISTOLERO PL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-8086
Country	:	US
Telephone Number	:	575-993-3504
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	KYLAH MILLER
Credential	:	LMSW, LADAC
Telephone Number	:	575-993-3504

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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