Provider Demographics
NPI:1861084402
Name:STEPPING STONE DEVELOPMENT LLC
Entity type:Organization
Organization Name:STEPPING STONE DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OXENDINE-MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-885-8813
Mailing Address - Street 1:65 MCCOY RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-5436
Mailing Address - Country:US
Mailing Address - Phone:910-885-8813
Mailing Address - Fax:
Practice Address - Street 1:65 MCCOY RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-5436
Practice Address - Country:US
Practice Address - Phone:910-885-8813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC101YM0900XMedicaid