Provider Demographics
NPI:1194076547
Name:STEPPING STONES INTERVENTION SERVICES INC
Entity type:Organization
Organization Name:STEPPING STONES INTERVENTION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:404-274-0753
Mailing Address - Street 1:2763 HIGHWAY 138 E STE A
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-2763
Mailing Address - Country:US
Mailing Address - Phone:404-274-0753
Mailing Address - Fax:
Practice Address - Street 1:153 BERRYWOOD CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-9244
Practice Address - Country:US
Practice Address - Phone:404-274-0753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003694251C00000X
GA06888251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services