Healthcare Provider Details

I. General information

NPI: 1700106903
Provider Name (Legal Business Name): STEPPING STONES CHILD PLACEMENT AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 06/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E 2100 S STE 100
SALT LAKE CITY UT
84115-2300
US

IV. Provider business mailing address

180 E 2100 S STE 100
SALT LAKE CITY UT
84115-2300
US

V. Phone/Fax

Practice location:
  • Phone: 801-493-2100
  • Fax: 801-493-2103
Mailing address:
  • Phone: 801-493-2100
  • Fax: 801-493-2103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number16555
License Number StateUT

VIII. Authorized Official

Name: MS. JODY LYN VALDEZ
Title or Position: CEO
Credential:
Phone: 801-493-2100