Healthcare Provider Details

I. General information

NPI: 1699474650
Provider Name (Legal Business Name): STEPPING STONES OF FAITH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 02/28/2023
Certification Date: 02/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STATE ROAD 110 HOUSE 35 B
EL RITO NM
87530-8753
US

IV. Provider business mailing address

PO BOX 365
EL RITO NM
87530-0365
US

V. Phone/Fax

Practice location:
  • Phone: 505-927-1564
  • Fax:
Mailing address:
  • Phone: 505-927-1564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LEANN ARCHULETA
Title or Position: OWNER
Credential: LCSW
Phone: 505-927-1564