Provider Demographics
NPI:1194752873
Name:THE LEAVES INC
Entity type:Organization
Organization Name:THE LEAVES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-890-3427
Mailing Address - Street 1:1230 W SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7709
Mailing Address - Country:US
Mailing Address - Phone:972-231-4864
Mailing Address - Fax:972-643-3500
Practice Address - Street 1:1230 W SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-7709
Practice Address - Country:US
Practice Address - Phone:972-231-4864
Practice Address - Fax:972-643-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX451990Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER