Provider Demographics
NPI:1417429507
Name:INCLUSIVE HEARTS - ABILITY DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:INCLUSIVE HEARTS - ABILITY DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORDYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEASURE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:559-395-2459
Mailing Address - Street 1:1930 HOWARD RD STE 119
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5155
Mailing Address - Country:US
Mailing Address - Phone:559-395-2459
Mailing Address - Fax:
Practice Address - Street 1:1930 HOWARD RD STE 119
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5155
Practice Address - Country:US
Practice Address - Phone:559-395-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-30
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health