Organization
LEAP OF FAITH ADULT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA WILLIAMS BOOKER RN,BSN (PROGRAM DIRECTOR/QDDP/OWNER)
(804) 605-7883
Entity
Organization
Contact information
Practice address
528 VIRGINIA AVE, PETERSBURG, VA 23803-5759
(804) 605-7883
Mailing address
4409 TEAL CIR, NORTH DINWIDDIE, VA 23803-6882
(804) 926-3744
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
09/19/2020
Last updated
09/19/2020
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