Organization Name: | LEADERSHIP PROFESSIONIALS INC |
NPI Number: | 1023254968 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACKY BACK (PRESIDENT) |
Mailing Address: | 1511a Rainbow Dr Gadsden |
State: | AL US |
Postal Code: | 359015370 |
Phone Number: | 2565438880 |
Fax Number: | 2565438889 |
NPI Enumeration Date: | 12/24/2008 |
NPI Last Update Date: | 12/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |