Organization
LEAP OF FAITH ACRES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SHADE (EXECUTIVE DIRECTOR)
(727) 389-3056
Entity
Organization
Contact information
Practice address
14315 FAMILY TRL, HUDSON, FL 34669-3643
(727) 389-3056
Mailing address
14315 FAMILY TRL, HUDSON, FL 34669-3643
(727) 389-3056
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/14/2019
Last updated
03/14/2019
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