Provider Demographics
NPI:1871902932
Name:STEPPING STONE HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:STEPPING STONE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:UGBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-759-1722
Mailing Address - Street 1:6475 E MAIN ST
Mailing Address - Street 2:STE 137
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-7316
Mailing Address - Country:US
Mailing Address - Phone:614-759-1722
Mailing Address - Fax:614-759-1755
Practice Address - Street 1:6475 E MAIN ST
Practice Address - Street 2:STE 137
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-7316
Practice Address - Country:US
Practice Address - Phone:614-759-1722
Practice Address - Fax:614-759-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-03
Last Update Date:2014-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0057607Medicaid