Healthcare Provider Details

I. General information

NPI: 1215005913
Provider Name (Legal Business Name): LEAPS AND BOUNDS THERAPY SERVICES L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8542 W GRAND RIVER AVE
BRIGHTON MI
48116-2326
US

IV. Provider business mailing address

8542 W GRAND RIVER AVE
BRIGHTON MI
48116-2326
US

V. Phone/Fax

Practice location:
  • Phone: 734-449-4649
  • Fax: 734-449-4669
Mailing address:
  • Phone: 734-449-4649
  • Fax: 734-449-4669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALISON J BARNETT
Title or Position: PT, DPT, PRESIDENT
Credential:
Phone: 734-449-4649