Organization
LEVELED UP REENTRY
Active
Other names
Leveled Up Reentry
Organization subpart
No
Provider details
NPI number
Authorized official
LATANISHA BOOKER (CEO)
(253) 878-8888
Entity
Organization
Contact information
Practice address
7821 S PARK AVE, TACOMA, WA 98408-5314
(253) 878-8888
Mailing address
4227 S MERIDIAN STE D421, PUYALLUP, WA 98373-3603
(253) 878-8888
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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