Provider Demographics
NPI:1992204705
Name:LITTLE LEAPS THERAPY
Entity type:Organization
Organization Name:LITTLE LEAPS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:FALKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-791-6106
Mailing Address - Street 1:16249 CELTIC CIR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-6100
Mailing Address - Country:US
Mailing Address - Phone:815-791-6106
Mailing Address - Fax:
Practice Address - Street 1:16249 CELTIC CIR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:IL
Practice Address - Zip Code:60442-6100
Practice Address - Country:US
Practice Address - Phone:815-791-6106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILLF84050415P222Q00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty