Provider Demographics
NPI:1396157749
Name:A STEP ABOVE COMPANION SERVICES
Entity type:Organization
Organization Name:A STEP ABOVE COMPANION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WIMBERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-691-4742
Mailing Address - Street 1:PO BOX 3728
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29230-3728
Mailing Address - Country:US
Mailing Address - Phone:803-691-4742
Mailing Address - Fax:866-942-7888
Practice Address - Street 1:809 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3744
Practice Address - Country:US
Practice Address - Phone:407-535-2780
Practice Address - Fax:866-942-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233543253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care