Organization
GOLD LEAF ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRI GAIL COOMER (PRESIDENT)
(573) 243-9900
Entity
Organization
Contact information
Practice address
1166 GREENWAY DR, SUITE B5, JACKSON, MO 63755-2913
(573) 243-9900
(573) 243-5320
Mailing address
1166 GREENWAY DR, SUITE B5, JACKSON, MO 63755-2913
(573) 243-9900
(573) 243-5320
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
214985
MO
171M00000X
Case Manager/Care Coordinator
—
—
343900000X
Non-emergency Medical Transport (VAN)
1706830
MO
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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