Provider Demographics
NPI:1881656734
Name:A STEP AHEAD THERAPY CENTER, INC.
Entity Type:Organization
Organization Name:A STEP AHEAD THERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALECA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-234-3736
Mailing Address - Street 1:3606 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5731
Mailing Address - Country:US
Mailing Address - Phone:319-234-3736
Mailing Address - Fax:319-234-0401
Practice Address - Street 1:3606 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5731
Practice Address - Country:US
Practice Address - Phone:319-234-3736
Practice Address - Fax:319-234-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02547174400000X
IA03011174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA35404OtherWELLMARK INDIVIDUAL NUMBE
IA0415620Medicaid
IA35403OtherWELLMARK INDIVIDUAL NUMBE
IA0415612Medicaid
IA0415638Medicaid
IA35402OtherWELLMARK OF IOWA
IA0415620Medicaid
IA0415612Medicaid
IA35403OtherWELLMARK INDIVIDUAL NUMBE