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General NPI Number Information
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NPI Number | 1609405943
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Entity Type | Organization
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Legal Business Name | LEADING BY EXAMPLE LLC
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 5026 CAMPBELL BLVD STE H
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City | NOTTINGHAM
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State | MD
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Zip | 21236-5051
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Country | US
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Telephone | 410-780-2692
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Fax | 410-480-2694
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Provider Business Mailing Address
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Address Line | 5026 CAMPBELL BLVD STE H
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City | NOTTINGHAM
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State | MD
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Zip | 21236-5051
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Country | US
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Telephone | 410-780-2692
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Fax | 410-480-2694
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JOHNNIE LOUIS FIELDING
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Credential |
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Telephone | 410-780-2692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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