Provider Demographics
NPI:1508922931
Name:STEPPING STONE CENTER FOR RECOVERY, LLC
Entity Type:Organization
Organization Name:STEPPING STONE CENTER FOR RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR BILLING/COLLECTIONS
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-691-0856
Mailing Address - Street 1:1815 CORPORATE SQUARE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-0325
Mailing Address - Country:US
Mailing Address - Phone:904-446-1041
Mailing Address - Fax:954-491-4193
Practice Address - Street 1:1815 CORPORATE SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-0325
Practice Address - Country:US
Practice Address - Phone:904-446-1041
Practice Address - Fax:904-855-4364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0416AD910500324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility