Provider Demographics
NPI:1104416866
Name:LEARNING LEAPS BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:LEARNING LEAPS BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:OSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-455-3524
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-1554
Mailing Address - Country:US
Mailing Address - Phone:352-508-5243
Mailing Address - Fax:
Practice Address - Street 1:465 W ARDICE AVE
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6573
Practice Address - Country:US
Practice Address - Phone:352-508-5243
Practice Address - Fax:352-602-4142
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEARNING LEAPS BEHAVIORAL SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health