Provider Demographics
NPI:1902426273
Name:NEW STEPS RESIDENTIAL CARE L L C
Entity type:Organization
Organization Name:NEW STEPS RESIDENTIAL CARE L L C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ABOLADE
Authorized Official - Middle Name:AKEEM
Authorized Official - Last Name:SANUSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-364-1098
Mailing Address - Street 1:17592 W HADLEY ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-4030
Mailing Address - Country:US
Mailing Address - Phone:480-364-1098
Mailing Address - Fax:480-546-3574
Practice Address - Street 1:17592 W HADLEY ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-4030
Practice Address - Country:US
Practice Address - Phone:623-932-7888
Practice Address - Fax:480-546-3574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ003675Medicaid