Provider Demographics
NPI:1083953095
Name:STEPPING STONE SUPPORT CENTER INC
Entity Type:Organization
Organization Name:STEPPING STONE SUPPORT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BALDASSARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-839-4626
Mailing Address - Street 1:9032 W KEN CARYL AVE # A1-A3
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-9330
Mailing Address - Country:US
Mailing Address - Phone:720-839-4626
Mailing Address - Fax:
Practice Address - Street 1:9032 W KEN CARYL AVE # A1-A3
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-9330
Practice Address - Country:US
Practice Address - Phone:720-839-4626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-11
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47908866Medicaid