Healthcare Provider Details

I. General information

NPI: 1770299752
Provider Name (Legal Business Name): STEPPING STONE BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4732 W LEMON AVE
COOLIDGE AZ
85128-8276
US

IV. Provider business mailing address

270 E HUNT HWY STE 16 #317
SAN TAN VALLEY AZ
85143
US

V. Phone/Fax

Practice location:
  • Phone: 520-519-9465
  • Fax:
Mailing address:
  • Phone: 520-519-9465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NAXANDRA M PAIN
Title or Position: MEMBER, BHT
Credential:
Phone: 520-519-9465