Provider Demographics
NPI:1154204808
Name:PSYCHSTEP RESIDENTIAL LLC
Entity type:Organization
Organization Name:PSYCHSTEP RESIDENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHMP
Authorized Official - Phone:214-853-3536
Mailing Address - Street 1:9711 S MASON RD STE 125-380
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7167
Mailing Address - Country:US
Mailing Address - Phone:346-586-6935
Mailing Address - Fax:
Practice Address - Street 1:9711 S MASON RD STE 125380
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7167
Practice Address - Country:US
Practice Address - Phone:346-586-6935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-29
Last Update Date:2025-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities