Provider Demographics
NPI:1841723020
Name:AWESOME STEP DEVELOPMENT
Entity type:Organization
Organization Name:AWESOME STEP DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-908-0014
Mailing Address - Street 1:6316 SAN JUAN AVE
Mailing Address - Street 2:STE. 15A
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-2831
Mailing Address - Country:US
Mailing Address - Phone:904-802-7163
Mailing Address - Fax:904-672-7654
Practice Address - Street 1:6316 SAN JUAN AVE
Practice Address - Street 2:STE. 15A
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2831
Practice Address - Country:US
Practice Address - Phone:904-802-7163
Practice Address - Fax:904-672-7654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL006386700251E00000X, 253Z00000X, 385H00000X, 385HR2055X, 385HR2060X, 385HR2065X
FL002552700253Z00000X, 385H00000X, 385HR2055X, 385HR2060X, 385HR2065X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite 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
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002552700Medicaid
FL006386700Medicaid
FL16814OtherHOMEMAKER AND COMPANION SERVICES