Provider Demographics
NPI:1801163381
Name:STEP LIFE,LLC
Entity type:Organization
Organization Name:STEP LIFE,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SKIPPY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-406-0500
Mailing Address - Street 1:2012 ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-6006
Mailing Address - Country:US
Mailing Address - Phone:573-406-0500
Mailing Address - Fax:573-406-0502
Practice Address - Street 1:2012 ORCHARD AVE
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6006
Practice Address - Country:US
Practice Address - Phone:573-406-0500
Practice Address - Fax:573-406-0502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child