MEDICARE: STEPPING STONES TOWARD THE FUTURE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	1454	VA

General Provider Information

NPI Number	:	1194014878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPPING STONES TOWARD THE FUTURE LLC

Provider Business Mailing Address
First Line	:	3806 OLD POST RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23234-2024
Country	:	US
Telephone Number	:	804-283-1422
Fax Number	:

Provider Business Practice Location Address
First Line	:	6767 FOREST HILL AVE
Second Line	:	SUITES 3 AND 4
City	:	RICHMOND
State	:	VA
Zip	:	23225-1856
Country	:	US
Telephone Number	:	804-283-1422
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MRS. TIFNEY LEQUITA WARD HAIRSTON
Credential	:
Telephone Number	:	804-283-1422

Provider Enumeration Date	:	04/01/2011
Last Update Date	:	04/01/2011

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