| Leap Llc | |
|
1858 Triplett St Owensboro KY 42303-3858 | |
| (270) 414-0145 | |
| (270) 414-0146 |
| Full Name | Leap Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1858 Triplett St, Owensboro, Kentucky |
| Authorized Official Name and Position | Melissa Hayden (OWNER) |
| Authorized Official Contact | 8127598271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leap Llc Po Box 1654 Evansville IN 47706-0055 Ph: (270) 414-0145 | Leap Llc 1858 Triplett St Owensboro KY 42303-3858 Ph: (270) 414-0145 |
| NPI Number | 1538985684 |
|---|---|
| Provider Enumeration Date | 11/22/2024 |
| Last Update Date | 12/02/2024 |
| Certification Date | 12/02/2024 |
| Medicare PECOS PAC ID | 1355870650 |
|---|---|
| Medicare Enrollment ID | O20250131001778 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538985684 | NPI | - | NPPES |
| Provider Name | Lonnie R Lyles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598059552 PECOS PAC ID: 0345547659 Enrollment ID: I20160331002702 |
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