Healthcare Provider Details

I. General information

NPI: 1871933267
Provider Name (Legal Business Name): STEPPING STONES THERAPY & IN HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 06/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 CABELAS PL
SUMTER SC
29150-7903
US

IV. Provider business mailing address

1661 CABELAS PL
SUMTER SC
29150-7903
US

V. Phone/Fax

Practice location:
  • Phone: 803-968-1118
  • Fax: 803-767-4190
Mailing address:
  • Phone: 803-968-1118
  • Fax: 803-767-4190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number3446
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number3446
License Number StateSC

VIII. Authorized Official

Name: DEIDRA MICHELLE GLOVER
Title or Position: OWNER
Credential: OTR/L
Phone: 803-968-1118