Provider Demographics
NPI:1487425104
Name:LEBOEUF LLC
Entity type:Organization
Organization Name:LEBOEUF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EDVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBOEUF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-955-5909
Mailing Address - Street 1:7635 W ONTARIO PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4405
Mailing Address - Country:US
Mailing Address - Phone:904-955-5909
Mailing Address - Fax:
Practice Address - Street 1:8500 W BOWLES AVE STE 315
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3276
Practice Address - Country:US
Practice Address - Phone:720-213-6015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)