Provider Demographics
NPI:1235381633
Name:LEAP AHEAD, INC.
Entity Type:Organization
Organization Name:LEAP AHEAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/BEHAVIORAL CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TALISHA
Authorized Official - Middle Name:AUTUMN
Authorized Official - Last Name:SACHLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:703-392-6166
Mailing Address - Street 1:10686 CRESTWOOD DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-4407
Mailing Address - Country:US
Mailing Address - Phone:703-392-6166
Mailing Address - Fax:703-392-3885
Practice Address - Street 1:10686 CRESTWOOD DR
Practice Address - Street 2:SUITE B
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-4407
Practice Address - Country:US
Practice Address - Phone:703-392-6166
Practice Address - Fax:703-392-3885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency