Provider Demographics
NPI:1245711654
Name:STEPS SOUTH LLC
Entity type:Organization
Organization Name:STEPS SOUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURIO
Authorized Official - Middle Name:TERRELL
Authorized Official - Last Name:MCKELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-640-0555
Mailing Address - Street 1:PO BOX 1163
Mailing Address - Street 2:
Mailing Address - City:PRENTISS
Mailing Address - State:MS
Mailing Address - Zip Code:39474-1163
Mailing Address - Country:US
Mailing Address - Phone:601-640-0555
Mailing Address - Fax:
Practice Address - Street 1:107 DEWITT CIRCLE
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402
Practice Address - Country:US
Practice Address - Phone:702-518-5928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty