Provider Demographics
NPI:1194117697
Name:STEP N2 RECOVERY SERVICES
Entity type:Organization
Organization Name:STEP N2 RECOVERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, CSC-AD
Authorized Official - Phone:443-607-6207
Mailing Address - Street 1:44101 AIRPORT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636-3145
Mailing Address - Country:US
Mailing Address - Phone:443-975-7010
Mailing Address - Fax:443-968-2030
Practice Address - Street 1:44101 AIRPORT VIEW DR
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:MD
Practice Address - Zip Code:20636-3145
Practice Address - Country:US
Practice Address - Phone:443-975-7010
Practice Address - Fax:443-968-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSCO681251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1144499674Medicaid