Provider Demographics
NPI:1841431517
Name:POSITIVE STEPS RESIDENTIAL SERVICES #2
Entity Type:Organization
Organization Name:POSITIVE STEPS RESIDENTIAL SERVICES #2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIKA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:252-567-3461
Mailing Address - Street 1:748 NC HIGHWAY 33 E
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-8927
Mailing Address - Country:US
Mailing Address - Phone:252-567-3461
Mailing Address - Fax:
Practice Address - Street 1:115 WYE ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-5679
Practice Address - Country:US
Practice Address - Phone:252-567-3461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-033-57322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children