Provider Demographics
NPI:1508685157
Name:NEXT STEP BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:NEXT STEP BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HARONIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVAREZ DE OLIVEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-207-9780
Mailing Address - Street 1:3757 CLAY DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-9233
Mailing Address - Country:US
Mailing Address - Phone:718-207-9780
Mailing Address - Fax:
Practice Address - Street 1:3757 CLAY DR
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-9233
Practice Address - Country:US
Practice Address - Phone:718-207-9780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health