MEDICARE: TURNING LEAF THERAPEUTIC & SOCIAL SERVICES, 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	251V00000X	Voluntary or Charitable Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811322712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TURNING LEAF THERAPEUTIC & SOCIAL SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 12
Second Line	:
City	:	LEXINGTON
State	:	TN
Zip	:	38351-0012
Country	:	US
Telephone Number	:	931-629-1116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1004 ANNAPOLIS AVE
Second Line	:
City	:	SHEFFIELD
State	:	AL
Zip	:	35660-7538
Country	:	US
Telephone Number	:	931-629-1116
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. ANGEL GIESKE
Credential	:	PHD, MBAT
Telephone Number	:	931-629-1116

Provider Enumeration Date	:	09/10/2013
Last Update Date	:	09/10/2013

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