Provider Demographics
NPI:1487483418
Name:LEAP OF FAITH RECOVERY
Entity type:Organization
Organization Name:LEAP OF FAITH RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECCTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:LICDC-CS
Authorized Official - Phone:330-849-4034
Mailing Address - Street 1:5884 KNAPP RD
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-8848
Mailing Address - Country:US
Mailing Address - Phone:330-849-4034
Mailing Address - Fax:
Practice Address - Street 1:5884 KNAPP RD
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-8848
Practice Address - Country:US
Practice Address - Phone:330-849-4034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder