Provider Demographics
NPI:1861137069
Name:A STEP ABOVE CASE MANAGEMENT
Entity type:Organization
Organization Name:A STEP ABOVE CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-790-0317
Mailing Address - Street 1:50 HURT PLZ SE STE 1108
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2946
Mailing Address - Country:US
Mailing Address - Phone:404-400-2218
Mailing Address - Fax:404-220-9450
Practice Address - Street 1:50 HURT PLZ SE STE 1108
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2946
Practice Address - Country:US
Practice Address - Phone:404-400-2218
Practice Address - Fax:404-220-9450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003228805AMedicaid