MEDICARE: LEAP WAY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	385HR2055X	Child Mental Illness Respite Care
2	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
3	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
4	320800000X	Mental Illness Community Based Residential Treatment Facility
5	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
6	3104A0625X	Assisted Living Facility (Mental Illness)
7	385H00000X	Respite Care
8	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1952126823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEAP WAY LLC

Provider Business Mailing Address
First Line	:	PO BOX 250559
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53225-6507
Country	:	US
Telephone Number	:	414-573-4147
Fax Number	:

Provider Business Practice Location Address
First Line	:	1436 N 26TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1821
Country	:	US
Telephone Number	:	414-526-8985
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS KAMISHA J BOYD
Credential	:
Telephone Number	:	414-573-4147

Provider Enumeration Date	:	11/18/2024
Last Update Date	:	05/18/2026

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Directions to “LEAP WAY LLC ” Practice Location

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