Organization
LEAPS-ASD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY BORDEN (PRESIDENT)
(863) 241-4843
Entity
Organization
Contact information
Practice address
1917 SIXTY OAKS LN, VERO BEACH, FL 32966-1078
(863) 241-4843
Mailing address
1917 SIXTY OAKS LN, VERO BEACH, FL 32966-1078
(863) 241-4843
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0-02-0431
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700216231
INDIVIDUAL NPI #
FL
Enumeration date
06/30/2015
Last updated
06/30/2015
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