=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396980736
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEAPS & BOUNDS ORGANIZATION OF HOUSTON
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2008
-----------------------------------------------------
Last Update Date | 12/15/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3718 BLACK LOCUST DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77088-6922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-272-7931
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3718 BLACK LOCUST DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77088-6922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-272-7931
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. NATASHA TERRIE RILEY-WHITE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 832-272-7931
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------