Provider Demographics
NPI:1568626190
Name:A STEP FORWARD BEHAVIORAL SERVICES, LLC
Entity Type:Organization
Organization Name:A STEP FORWARD BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:JACK
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-894-0092
Mailing Address - Street 1:60 E RIO SALADO PKWY
Mailing Address - Street 2:STE 900
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-9124
Mailing Address - Country:US
Mailing Address - Phone:480-894-0092
Mailing Address - Fax:480-894-0093
Practice Address - Street 1:2500 E COOLEY ST
Practice Address - Street 2:401
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-5271
Practice Address - Country:US
Practice Address - Phone:928-537-9744
Practice Address - Fax:928-537-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ158270251S00000X, 385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child