Provider Demographics
NPI:1205676145
Name:STEPPING STONE SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:STEPPING STONE SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOKO
Authorized Official - Middle Name:ABRAHIM
Authorized Official - Last Name:SIRLEAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-577-2718
Mailing Address - Street 1:11901 CENTRAL PARK WAY UNIT 2427
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-2669
Mailing Address - Country:US
Mailing Address - Phone:267-577-2718
Mailing Address - Fax:
Practice Address - Street 1:11901 CENTRAL PARK WAY UNIT 2427
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-2669
Practice Address - Country:US
Practice Address - Phone:267-577-2718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center