Provider Demographics
NPI:1538853635
Name:POSITIVE STEPS NC LLC
Entity type:Organization
Organization Name:POSITIVE STEPS NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARA
Authorized Official - Middle Name:NATAKA ADESIMBO
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:336-840-9609
Mailing Address - Street 1:6359 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:SNOW CAMP
Mailing Address - State:NC
Mailing Address - Zip Code:27349-9015
Mailing Address - Country:US
Mailing Address - Phone:336-840-9609
Mailing Address - Fax:
Practice Address - Street 1:108 N FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:27298-3203
Practice Address - Country:US
Practice Address - Phone:336-840-9609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty