MEDICARE: STEP ONE HALFWAY HOUSE

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	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1972342251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEP ONE HALFWAY HOUSE

Provider Business Mailing Address
First Line	:	9636 N 11TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-3004
Country	:	US
Telephone Number	:	602-749-5434
Fax Number	:

Provider Business Practice Location Address
First Line	:	9636 N 11TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-3004
Country	:	US
Telephone Number	:	602-749-5434
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. SHELBY LEE
Credential	:	BHT
Telephone Number	:	602-601-9254

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	05/24/2024

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Directions to “STEP ONE HALFWAY HOUSE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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