Provider Demographics
NPI:1932733243
Name:A STEP ABOVE, LLC
Entity Type:Organization
Organization Name:A STEP ABOVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:MANZANO
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MBA
Authorized Official - Phone:408-981-8713
Mailing Address - Street 1:2111 OCEAN AVE.
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127
Mailing Address - Country:US
Mailing Address - Phone:408-981-8713
Mailing Address - Fax:925-848-3614
Practice Address - Street 1:3648 DELTA FAIR BLVD.
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-481-2189
Practice Address - Fax:925-848-3614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care