Provider Demographics
NPI:1861898116
Name:STEP BY STEP CARE, INC
Entity type:Organization
Organization Name:STEP BY STEP CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVONDELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:STALLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-689-8902
Mailing Address - Street 1:709 E MARKET ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-3265
Mailing Address - Country:US
Mailing Address - Phone:336-378-0109
Mailing Address - Fax:336-378-0180
Practice Address - Street 1:1320 MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3204
Practice Address - Country:US
Practice Address - Phone:803-724-1250
Practice Address - Fax:803-724-1201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEP BY STEP CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-14
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC=========OtherEMPLOYER IDENTIFICATION NUMBER