Provider Demographics
NPI:1568994226
Name:STEPPING STONES MENTAL HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:STEPPING STONES MENTAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ULMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-380-5813
Mailing Address - Street 1:105 CENTER AVE N
Mailing Address - Street 2:
Mailing Address - City:MADELIA
Mailing Address - State:MN
Mailing Address - Zip Code:56062-1429
Mailing Address - Country:US
Mailing Address - Phone:507-380-5813
Mailing Address - Fax:507-642-8583
Practice Address - Street 1:105 CENTER AVE N
Practice Address - Street 2:
Practice Address - City:MADELIA
Practice Address - State:MN
Practice Address - Zip Code:56062-1429
Practice Address - Country:US
Practice Address - Phone:507-380-5813
Practice Address - Fax:507-642-8583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN936690200023OtherSTATE OF MINNESOTA