Provider Demographics
NPI:1184097479
Name:STEP FORWARD, INCORPORATED
Entity type:Organization
Organization Name:STEP FORWARD, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:STEPNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-230-4165
Mailing Address - Street 1:3307 UNIVERSITY AVENUE SE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414
Mailing Address - Country:US
Mailing Address - Phone:612-315-2242
Mailing Address - Fax:612-979-2613
Practice Address - Street 1:3307 UNIVERSITY AVE SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3325
Practice Address - Country:US
Practice Address - Phone:612-315-2242
Practice Address - Fax:612-979-2613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNHFID-31947320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness