Provider Demographics
NPI:1811322712
Name:TURNING LEAF THERAPEUTIC & SOCIAL SERVICES, INC
Entity type:Organization
Organization Name:TURNING LEAF THERAPEUTIC & SOCIAL SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GIESKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MBAT
Authorized Official - Phone:931-629-1116
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-0012
Mailing Address - Country:US
Mailing Address - Phone:931-629-1116
Mailing Address - Fax:
Practice Address - Street 1:1004 ANNAPOLIS AVE
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-7538
Practice Address - Country:US
Practice Address - Phone:931-629-1116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL339030036Medicaid
AL339017043Medicaid
AL339037343Medicaid
AL339039081Medicaid