Healthcare Provider Details

I. General information

NPI: 1487391447
Provider Name (Legal Business Name): STEPPING STONES COMMUNITY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 N IRONWOOD RD STE 216B
MILWAUKEE WI
53217-4908
US

IV. Provider business mailing address

5215 N IRONWOOD RD STE 216B
MILWAUKEE WI
53217-4908
US

V. Phone/Fax

Practice location:
  • Phone: 414-595-0449
  • Fax:
Mailing address:
  • Phone: 414-595-0449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LAKESHA REID
Title or Position: OWNER
Credential: SAC-IT
Phone: 414-595-0449