Provider Demographics
NPI:1427327790
Name:LEARY EDUCATIONAL FOUNDATIN, INC
Entity type:Organization
Organization Name:LEARY EDUCATIONAL FOUNDATIN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-888-3456
Mailing Address - Street 1:PO BOX 3160
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22604-2360
Mailing Address - Country:US
Mailing Address - Phone:540-888-3456
Mailing Address - Fax:
Practice Address - Street 1:1463 NEW HOPE RD
Practice Address - Street 2:
Practice Address - City:CROSS JUNCTION
Practice Address - State:VA
Practice Address - Zip Code:22625-2035
Practice Address - Country:US
Practice Address - Phone:540-888-3456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA493-05-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health