Provider Demographics
NPI:1518119965
Name:STEPS ULTIMATE SOLUTIONS
Entity Type:Organization
Organization Name:STEPS ULTIMATE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-242-1300
Mailing Address - Street 1:18031 US HIGHWAY 18 STE F
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2152
Mailing Address - Country:US
Mailing Address - Phone:760-242-1300
Mailing Address - Fax:760-242-1331
Practice Address - Street 1:18031 US HIGHWAY 18 STE F
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2152
Practice Address - Country:US
Practice Address - Phone:760-242-1300
Practice Address - Fax:760-242-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA360078AP101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36ANMedicaid