MEDICARE: STEPPING STONES GROUP HOMES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1023531886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPPING STONES GROUP HOMES INC

Provider Business Mailing Address
First Line	:	4883 HWY 47
Second Line	:
City	:	CHASE CITY
State	:	VA
Zip	:	23924-3606
Country	:	US
Telephone Number	:	434-372-0407
Fax Number	:

Provider Business Practice Location Address
First Line	:	4883 HWY 47
Second Line	:
City	:	CHASE CITY
State	:	VA
Zip	:	23924-3606
Country	:	US
Telephone Number	:	434-372-0407
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIFFANY TERRY
Credential	:
Telephone Number	:	434-372-0407

Provider Enumeration Date	:	07/24/2017
Last Update Date	:	07/21/2022

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