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General NPI Number Information
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NPI Number | 1447425459
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Entity Type | Organization
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Legal Business Name | STEPPING STONE, INC.
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | RR 6 BOX 160C
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City | FAIRMONT
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State | WV
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Zip | 26554-9116
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Country | US
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Telephone | 304-366-8571
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Fax | 304-368-0795
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Provider Business Mailing Address
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Address Line | PO BOX 2054
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City | FAIRMONT
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State | WV
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Zip | 26555-2054
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Country | US
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Telephone | 304-366-8571
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Fax | 304-368-0795
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. HEATHER GALLAGHER
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Credential |
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Telephone | 304-366-8571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 08GRR001
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License Number State | WV
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