Provider Demographics
NPI:1558808105
Name:FIRST LEAPS TOGETHER, LLC
Entity Type:Organization
Organization Name:FIRST LEAPS TOGETHER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:SCHERMERHORN
Authorized Official - Last Name:BORDELEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MAED, BCBA
Authorized Official - Phone:860-381-5537
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:LEDYARD
Mailing Address - State:CT
Mailing Address - Zip Code:06339-0306
Mailing Address - Country:US
Mailing Address - Phone:860-381-5537
Mailing Address - Fax:860-381-5712
Practice Address - Street 1:758R COLONEL LEDYARD HWY
Practice Address - Street 2:
Practice Address - City:LEDYARD
Practice Address - State:CT
Practice Address - Zip Code:06339-1570
Practice Address - Country:US
Practice Address - Phone:860-381-5537
Practice Address - Fax:860-381-5712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty