Provider Demographics
NPI:1932744745
Name:STEPWORKS RECOVERY CENTERS LLC
Entity type:Organization
Organization Name:STEPWORKS RECOVERY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:HARPOOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-317-0169
Mailing Address - Street 1:PO BOX 6209
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-6209
Mailing Address - Country:US
Mailing Address - Phone:888-259-0031
Mailing Address - Fax:
Practice Address - Street 1:2410 RING RD STE 500
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7991
Practice Address - Country:US
Practice Address - Phone:270-765-5900
Practice Address - Fax:270-982-1284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health