Provider Demographics
NPI:1588338685
Name:STEPPING STONE TREATMENT CENTER, LLC
Entity type:Organization
Organization Name:STEPPING STONE TREATMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:T
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:630-408-1611
Mailing Address - Street 1:3035 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-3714
Mailing Address - Country:US
Mailing Address - Phone:630-408-1611
Mailing Address - Fax:
Practice Address - Street 1:3035 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-3714
Practice Address - Country:US
Practice Address - Phone:630-408-1611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty