Provider Demographics
NPI:1942870928
Name:STEPPING STONES OF ROCKFORD, INC.
Entity Type:Organization
Organization Name:STEPPING STONES OF ROCKFORD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-963-0683
Mailing Address - Street 1:706 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-6904
Mailing Address - Country:US
Mailing Address - Phone:815-963-0683
Mailing Address - Fax:
Practice Address - Street 1:4317 MARAY DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-4967
Practice Address - Country:US
Practice Address - Phone:815-963-0883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPPING STONES OF ROCKFORD, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-30
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness