| Name: | Stepping Stone Pediatric Therapy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 04 Feb 2011 (14 years ago) |
| Entity Number: | 000-002-219 |
| Register Number: | 000002219 |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Principal Address: | 534 EAST LAKESIDEFLORENCE, AL 35630 |
| Principal Address ZIP Code: | 35630 |
| Authorized Capital: | 1,000 @ 1.00 PV |
| Paid Share Capital: | 100 |
Activities
PEDIATRIC THERAPY SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447542014 | 2011-05-13 | 2020-07-17 | 465 EAST DR. HICKS BLVD., FLORENCE, AL, 356305762, US | 465 EAST DR. HICKS BLVD., FLORENCE, AL, 356305762, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 256-767-1576 |
| Fax | 2567671577 |
Authorized person
| Name | MR. DAVID LEE AINSWORTH |
| Role | CEO |
| Phone | 2567671576 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | Yes |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 132065 |
| State | AL |
| Issuer | BCBS OF ALABAMA |
| Number | 511-87575 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| AINSWORTH, MIRANDA | Agent | 534 EAST LAKESIDEFLORENCE, AL 35630 |
| Name | Role | Address |
|---|---|---|
| AINSWORTH, DAVID | Director | 534 EAST LAKESIDEFLORENCE, AL 35630 |
| AINSWORTH, MIRANDA | Director | 534 EAST LAKESIDEFLORENCE, AL 35630 |
| Name | Role | Address |
|---|---|---|
| AINSWORTH, MIRANDA | Incorporator | 534 EAST LAKESIDEFLORENCE, AL 35630 |
Date of last update: 29 Jul 2024
Sources: Alabama Secretary of State
