Provider Demographics
NPI:1932360039
Name:POSITIVE STEPS RESIDENTIAL SERVICE, INC
Entity Type:Organization
Organization Name:POSITIVE STEPS RESIDENTIAL SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KIRBY
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-567-3462
Mailing Address - Street 1:748 NC HIGHWAY 33 E
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-8927
Mailing Address - Country:US
Mailing Address - Phone:252-567-3462
Mailing Address - Fax:252-823-5618
Practice Address - Street 1:464 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-9066
Practice Address - Country:US
Practice Address - Phone:252-567-3462
Practice Address - Fax:252-823-5618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-033-057322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children