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General NPI Number Information
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NPI Number | 1508922931
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Entity Type | Organization
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Legal Business Name | STEPPING STONE CENTER FOR RECOVERY, LLC
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 1815 CORPORATE SQUARE BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-0325
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Country | US
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Telephone | 904-446-1041
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Fax | 904-855-4364
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Provider Business Mailing Address
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Address Line | 1815 CORPORATE SQUARE BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-0325
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Country | US
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Telephone | 904-446-1041
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Fax | 954-491-4193
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Authorized Official
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Title or Position | DIRECTOR BILLING/COLLECTIONS
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Name | DONNA A CAMPBELL
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Credential |
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Telephone | 954-691-0856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 0416AD910500
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License Number State | FL
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