Provider Demographics
NPI:1194865212
Name:ONE STEP BEYOND, INC.
Entity Type:Organization
Organization Name:ONE STEP BEYOND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUIMMENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:505-438-2960
Mailing Address - Street 1:21 SANDS LANE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-9641
Mailing Address - Country:US
Mailing Address - Phone:505-438-2960
Mailing Address - Fax:505-438-2960
Practice Address - Street 1:21 SANDS LANE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-9641
Practice Address - Country:US
Practice Address - Phone:505-438-2960
Practice Address - Fax:505-438-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM69873704Medicaid
NM000D3744OtherMEDICAID WAIVER