Provider Demographics
NPI:1801587902
Name:STEP BEYOND THERAPY LLC
Entity type:Organization
Organization Name:STEP BEYOND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RECREATION THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CTRS
Authorized Official - Phone:507-556-4399
Mailing Address - Street 1:2063 EXCALIBUR LN
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-4422
Mailing Address - Country:US
Mailing Address - Phone:507-556-4399
Mailing Address - Fax:
Practice Address - Street 1:2063 EXCALIBUR LN
Practice Address - Street 2:
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-4422
Practice Address - Country:US
Practice Address - Phone:507-556-4399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Multi-Specialty