Provider Demographics
NPI:1437284494
Name:S.T.E.P'S DEVELOPMENTAL ACADEMY, INC.
Entity Type:Organization
Organization Name:S.T.E.P'S DEVELOPMENTAL ACADEMY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WELDON
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:704-882-9553
Mailing Address - Street 1:PO BOX 2007
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-2007
Mailing Address - Country:US
Mailing Address - Phone:704-532-5757
Mailing Address - Fax:704-532-5948
Practice Address - Street 1:1516B ALLEGHANY ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-0801
Practice Address - Country:US
Practice Address - Phone:980-207-1819
Practice Address - Fax:980-207-1832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409568Medicaid
NC8301170Medicaid