Provider Demographics
NPI:1164018826
Name:LEADING PUBLIC HEALTH ENTERPRISES, INC.
Entity Type:Organization
Organization Name:LEADING PUBLIC HEALTH ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINT-PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DMSC, PA, MPH
Authorized Official - Phone:831-200-3774
Mailing Address - Street 1:400 CORPORATE POINTE STE 300
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7620
Mailing Address - Country:US
Mailing Address - Phone:831-200-3774
Mailing Address - Fax:323-968-0006
Practice Address - Street 1:8732 S SEPULVEDA BLVD FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-4031
Practice Address - Country:US
Practice Address - Phone:831-200-2774
Practice Address - Fax:323-968-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty