Provider Demographics
NPI:1639461148
Name:LEADERS OF TOMORROW
Entity Type:Organization
Organization Name:LEADERS OF TOMORROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIAMESHA
Authorized Official - Middle Name:LIKAL
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-494-4442
Mailing Address - Street 1:365 N. NEW HOPE RD
Mailing Address - Street 2:STE 6.
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054
Mailing Address - Country:US
Mailing Address - Phone:704-494-4442
Mailing Address - Fax:
Practice Address - Street 1:365 N. NEW HOPE RD
Practice Address - Street 2:STE 6.
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054
Practice Address - Country:US
Practice Address - Phone:704-494-4442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health