Organization Name: | A STEP FORWARD INC. |
NPI Number: | 1205295102 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEREMY RAY MAUPIN (EXECUTIVE DIRECTOR) |
Mailing Address: | 5310 E William Street Rd Decatur |
State: | IL US |
Postal Code: | 625211874 |
Phone Number: | 2174226361 |
Fax Number: | |
NPI Enumeration Date: | 02/19/2016 |
NPI Last Update Date: | 02/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | 201200009S |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |