Provider Demographics
NPI:1316076755
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:QMRP
Authorized Official - Prefix:
Authorized Official - First Name:GREG
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:417-863-7007
Mailing Address - Fax:417-863-7007
Practice Address - Street 1:309 N JEFFERSON AVE
Practice Address - Street 2:SUITE 224
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65806-1108
Practice Address - Country:US
Practice Address - Phone:417-863-7007
Practice Address - Fax:417-863-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251C00000X, 385H00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Not Answered3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty