Provider Demographics
NPI:1255678561
Name:INNOVATIVE STEPS CO.
Entity Type:Organization
Organization Name:INNOVATIVE STEPS CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:DEVOR
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-821-9503
Mailing Address - Street 1:11450 US HIGHWAY 380 STE 130-130
Mailing Address - Street 2:
Mailing Address - City:CROSSROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-8321
Mailing Address - Country:US
Mailing Address - Phone:972-821-9503
Mailing Address - Fax:940-440-1301
Practice Address - Street 1:2601 LITTLE ELM PKWY STE 1102
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-1921
Practice Address - Country:US
Practice Address - Phone:972-821-9503
Practice Address - Fax:940-440-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2023-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities