Provider Demographics
NPI:1275830804
Name:SPECIALIZED TREATMENT, EDUCATION AND PREVENTION SERVICES, INC.
Entity Type:Organization
Organization Name:SPECIALIZED TREATMENT, EDUCATION AND PREVENTION SERVICES, INC.
Other - Org Name:STEPS, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:CCJAP
Authorized Official - Phone:407-522-2144
Mailing Address - Street 1:803 N FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-7309
Mailing Address - Country:US
Mailing Address - Phone:321-637-7730
Mailing Address - Fax:321-639-5721
Practice Address - Street 1:803 N FISKE BLVD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7309
Practice Address - Country:US
Practice Address - Phone:321-637-7730
Practice Address - Fax:321-639-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1805AD398603261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029951100Medicaid