Healthcare Provider Details

I. General information

NPI: 1558278267
Provider Name (Legal Business Name): LEAP OF FAITH RECOVERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 CANBY AVE
RESEDA CA
91335-3003
US

IV. Provider business mailing address

7211 CANBY AVE
RESEDA CA
91335-3003
US

V. Phone/Fax

Practice location:
  • Phone: 661-603-0127
  • Fax: 661-603-0127
Mailing address:
  • Phone: 661-603-0127
  • Fax: 661-603-0127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIANNA RAMOS
Title or Position: OWNER/CEO
Credential:
Phone: 661-603-0127