Provider Demographics
NPI:1376981852
Name:ONE STEP FORWARD, LLC
Entity Type:Organization
Organization Name:ONE STEP FORWARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-349-0736
Mailing Address - Street 1:5859 ABERCORN ST
Mailing Address - Street 2:STE 8
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5859 ABERCORN ST
Practice Address - Street 2:SUITE 8
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5500
Practice Address - Country:US
Practice Address - Phone:912-349-0736
Practice Address - Fax:912-349-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-06
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA995363939AMedicaid