MEDICARE: THE LEAVES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282J00000X	Religious Nonmedical Health Care Institution

General Provider Information

NPI Number	:	1194752873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LEAVES INC

Provider Business Mailing Address
First Line	:	1230 W SPRING VALLEY RD
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-7709
Country	:	US
Telephone Number	:	972-231-4864
Fax Number	:	972-643-3500

Provider Business Practice Location Address
First Line	:	1230 W SPRING VALLEY RD
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-7709
Country	:	US
Telephone Number	:	972-231-4864
Fax Number	:	972-643-3500

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	SUSAN M WEST
Credential	:
Telephone Number	:	972-890-3427

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	10/14/2022

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Directions to “THE LEAVES INC ” Practice Location

Language	Start Address	Practice Location

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