Provider Demographics
NPI:1417300088
Name:KY STEPS
Entity Type:Organization
Organization Name:KY STEPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:270-320-1101
Mailing Address - Street 1:2865 LAURELSTONE LN
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-4784
Mailing Address - Country:US
Mailing Address - Phone:270-202-6804
Mailing Address - Fax:270-846-4887
Practice Address - Street 1:2865 LAURELSTONE LN
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-4784
Practice Address - Country:US
Practice Address - Phone:270-202-6804
Practice Address - Fax:270-846-4887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY164686251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services