Healthcare Provider Details

I. General information

NPI: 1952667479
Provider Name (Legal Business Name): STEPPING STONE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21627 O TOOLE DR
HAGERSTOWN MD
21742-9753
US

IV. Provider business mailing address

21627 O TOOLE DR
HAGERSTOWN MD
21742-9753
US

V. Phone/Fax

Practice location:
  • Phone: 301-325-8208
  • Fax:
Mailing address:
  • Phone: 301-325-8208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberR096211
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR096211
License Number StateMD

VIII. Authorized Official

Name: MS. LORI JEAN SCHELLENBERG
Title or Position: REGISTERED NURSE
Credential: RN
Phone: 301-325-8208