Provider Information for 1861822132
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BOLD STEP, LLC
Other Names:Doing Business As:BEAUTY FOR ASHES MINISTRIESOrganization Subpart: NO
NPI: 1861822132
Last Updated: 2020-06-15
Certification Date: 2020-06-15
Certification Date: 2020-06-15
Details
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NPI | 1861822132 | ||||||||
Enumeration Date | 2013-11-22 | ||||||||
NPI Type | NPI-2 Organization | ||||||||
Status | Active | ||||||||
Authorized Official Information | Name: Mrs. CHEVALENE PALMER BARNES LCSW Title: Manager Phone: 9548265979 | ||||||||
Mailing Address | 1121 NW 111TH AVE PLANTATION, FL 33322-7826 United States Phone: 954-826-5979 | Fax: | ||||||||
Primary Practice Address | 1121 NW 111TH AVE PLANTATION, FL 33322-7826 United States Phone: 954-826-5979 | Fax: | ||||||||
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