Provider Demographics
NPI:1376104943
Name:STEP UP CARE OF OHIO LLC
Entity Type:Organization
Organization Name:STEP UP CARE OF OHIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NAFTALI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-506-1115
Mailing Address - Street 1:27 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-8611
Mailing Address - Country:US
Mailing Address - Phone:718-506-1115
Mailing Address - Fax:
Practice Address - Street 1:145 BAKER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4111
Practice Address - Country:US
Practice Address - Phone:718-506-1115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty