Provider Demographics
NPI:1760041487
Name:NEXT STEP RECOVERY, LLC
Entity Type:Organization
Organization Name:NEXT STEP RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:GOSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-254-7854
Mailing Address - Street 1:PO BOX K907
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-0830
Mailing Address - Country:US
Mailing Address - Phone:858-254-7854
Mailing Address - Fax:
Practice Address - Street 1:217 19TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-3905
Practice Address - Country:US
Practice Address - Phone:714-655-2635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health