Organization
A STEP FORWARD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY RAY MAUPIN (EXECUTIVE DIRECTOR)
(217) 422-6361
Entity
Organization
Contact information
Practice address
5310 E WILLIAM STREET RD, DECATUR, IL 62521-1874
(217) 422-6361
Mailing address
5310 E WILLIAM STREET RD, DECATUR, IL 62521-1874
(217) 422-6361
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
201200009S
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
201200009S
IL
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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