Provider Demographics
NPI:1770776106
Name:K AND C STEPPING STONES, LLC
Entity type:Organization
Organization Name:K AND C STEPPING STONES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAETHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-861-3578
Mailing Address - Street 1:PO BOX 9332
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-9332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:309 N JEFFERSON AVE
Practice Address - Street 2:STE 224
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65806-1108
Practice Address - Country:US
Practice Address - Phone:417-861-3578
Practice Address - Fax:417-863-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities