Provider Demographics
NPI:1336635622
Name:LEAPS ACADEMY INC
Entity type:Organization
Organization Name:LEAPS ACADEMY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-884-7621
Mailing Address - Street 1:1815 MARTIN ST S
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35128-2321
Mailing Address - Country:US
Mailing Address - Phone:205-884-7621
Mailing Address - Fax:
Practice Address - Street 1:2806 JOHN HAYNES DR
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-1485
Practice Address - Country:US
Practice Address - Phone:205-884-7621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4717225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty