Healthcare Provider Details

I. General information

NPI: 1194752873
Provider Name (Legal Business Name): THE LEAVES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 W SPRING VALLEY RD
RICHARDSON TX
75080-7709
US

IV. Provider business mailing address

1230 W SPRING VALLEY RD
RICHARDSON TX
75080-7709
US

V. Phone/Fax

Practice location:
  • Phone: 972-231-4864
  • Fax: 972-643-3500
Mailing address:
  • Phone: 972-231-4864
  • Fax: 972-643-3500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number State

VIII. Authorized Official

Name: SUSAN M WEST
Title or Position: BUSINESS MANAGER
Credential:
Phone: 972-890-3427