Provider Demographics
NPI:1043776834
Name:LEANONME GROUP LLC
Entity Type:Organization
Organization Name:LEANONME GROUP LLC
Other - Org Name:LEANONME PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIBAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-972-4767
Mailing Address - Street 1:318 W BELT LINE RD STE 304
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-1103
Mailing Address - Country:US
Mailing Address - Phone:972-972-4767
Mailing Address - Fax:972-972-4737
Practice Address - Street 1:318 W BELT LINE RD STE 304
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-1103
Practice Address - Country:US
Practice Address - Phone:972-972-4767
Practice Address - Fax:972-972-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-16
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty