| Step Forward South | |
|
1105 Broadway Ste 207 Chula Vista CA 91911-2767 | |
| (619) 425-5609 | |
| Not Available |
| Full Name | Step Forward South |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1105 Broadway Ste 207, Chula Vista, California |
| Authorized Official Name and Position | Jack Farmer (CAO) |
| Authorized Official Contact | 6192750822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Step Forward South 1105 Broadway Ste 207 Chula Vista CA 91911-2767 Ph: () - | Step Forward South 1105 Broadway Ste 207 Chula Vista CA 91911-2767 Ph: (619) 425-5609 |
| NPI Number | 1649794363 |
|---|---|
| Provider Enumeration Date | 08/03/2017 |
| Last Update Date | 02/23/2021 |
| Certification Date | 02/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649794363 | NPI | - | NPPES |
| 37RP | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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