Provider Demographics
NPI:1700106903
Name:STEPPING STONES CHILD PLACEMENT AGENCY
Entity type:Organization
Organization Name:STEPPING STONES CHILD PLACEMENT AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-493-2100
Mailing Address - Street 1:180 E 2100 S STE 100
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-2300
Mailing Address - Country:US
Mailing Address - Phone:801-493-2100
Mailing Address - Fax:801-493-2103
Practice Address - Street 1:180 E 2100 S STE 100
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-2300
Practice Address - Country:US
Practice Address - Phone:801-493-2100
Practice Address - Fax:801-493-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT16555253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1538488150Medicaid
UT1710948369Medicaid
UT1578528352Medicaid
UT1649354127Medicaid
UT1427376235Medicaid
UT1881635720Medicaid
UT1982683777Medicaid