Provider Demographics
NPI:1306661723
Name:STEPPING STONES HEALTH SERVICES LLC
Entity type:Organization
Organization Name:STEPPING STONES HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRISAK
Authorized Official - Middle Name:
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-484-0739
Mailing Address - Street 1:5255 W 82ND ST
Mailing Address - Street 2:215 #2
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55437
Mailing Address - Country:US
Mailing Address - Phone:612-484-0739
Mailing Address - Fax:
Practice Address - Street 1:5255 W 82ND ST
Practice Address - Street 2:215 #2
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55437
Practice Address - Country:US
Practice Address - Phone:612-484-0739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health