Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
261QP2300X | |||
Clinical Medical Laboratory |
291U00000X | 69 | Clinical Laboratory | |
Medical Specialty |
261QM2500X | |||
Medically Fragile Infants and Children Day Care |
261QM3000X | |||
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI # | 1962119487 |
| LBN Legal business name | LEADS WAY MEDICAL CENTER |
| Authorized official | ANTREANA SINGLETON-GRANT - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/03/2022 |
| Last updated | 11/03/2022 - About 4 years ago |
| Identifiers | n/a |
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LEADS WAY MEDICAL CENTER
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