Provider Demographics
NPI:1871846881
Name:STEP BY STEP INC
Entity Type:Organization
Organization Name:STEP BY STEP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-829-3477
Mailing Address - Street 1:744 KIDDER ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7015
Mailing Address - Country:US
Mailing Address - Phone:570-829-3477
Mailing Address - Fax:570-829-7918
Practice Address - Street 1:117 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-2616
Practice Address - Country:US
Practice Address - Phone:570-829-3477
Practice Address - Fax:570-829-7918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA218960320800000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000013970359OtherPA DPW PROMISE