Provider Demographics
NPI:1619182284
Name:LEADING LADIES
Entity Type:Organization
Organization Name:LEADING LADIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-864-3055
Mailing Address - Street 1:PO BOX 739
Mailing Address - Street 2:
Mailing Address - City:REEDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26547-0739
Mailing Address - Country:US
Mailing Address - Phone:304-864-3055
Mailing Address - Fax:
Practice Address - Street 1:RT 7, PLAZA
Practice Address - Street 2:
Practice Address - City:REEDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26547-0739
Practice Address - Country:US
Practice Address - Phone:304-864-3055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health