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General NPI Number Information
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NPI Number | 1770755027
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Entity Type | Organization
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Legal Business Name | LEADING EDGE SERVICES INTERNATIONAL INC
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3715 WILLIAMS BLVD SUITE 100
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City | KENNER
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State | LA
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Zip | 70065-3075
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Country | US
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Telephone | 504-468-6645
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Fax | 504-468-6646
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Provider Business Mailing Address
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Address Line | 3715 WILLIAMS BLVD SUITE 100
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City | KENNER
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State | LA
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Zip | 70065-3075
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Country | US
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Telephone | 504-468-6645
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Fax | 504-468-6646
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Authorized Official
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Title or Position | DIRECTOR OF SOCIAL SERVICES
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Name | HEIDI RAAPHORST
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Credential | LPC
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Telephone | 504-468-6645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | LA
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