Provider Demographics
NPI:1194310888
Name:STEPS 2WARDS SUCCESS LLC
Entity type:Organization
Organization Name:STEPS 2WARDS SUCCESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:I
Authorized Official - Credentials:N/A
Authorized Official - Phone:443-453-8555
Mailing Address - Street 1:111 OLD COURT RD STE B2
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4008
Mailing Address - Country:US
Mailing Address - Phone:443-213-8246
Mailing Address - Fax:443-213-8246
Practice Address - Street 1:111 OLD COURT RD STE B2
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4008
Practice Address - Country:US
Practice Address - Phone:443-213-8246
Practice Address - Fax:443-218-8246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD217029685Medicaid
MD83-1995378Medicaid