Organization
LEAP OF FAITH COMMUNITY OUTREACH LLC
Active
Organization
LEAP OF FAITH COMMUNITY OUTREACH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEMARIO D PHILLIPS (CEO)
(678) 612-4093
Entity
Organization
Contact information
Practice address
1755 THE EXCHANGE SE, SUITE 138, ATLANTA, GA 30339-7400
(770) 952-9272
(770) 952-9273
Mailing address
1458 INDIAN FOREST CT, STONE MOUNTAIN, GA 30083-5436
(404) 288-7266
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/14/2013
Last updated
05/21/2013
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