Provider Demographics
NPI:1639854789
Name:LEADING PATHS
Entity Type:Organization
Organization Name:LEADING PATHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMAIYAH
Authorized Official - Middle Name:JZAUNEE
Authorized Official - Last Name:ABDULRABB
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:470-242-1554
Mailing Address - Street 1:1774 MORGAN LN
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-5571
Mailing Address - Country:US
Mailing Address - Phone:141-232-6851
Mailing Address - Fax:
Practice Address - Street 1:1540 HIGHWAY 138 SE STE 4M
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1297
Practice Address - Country:US
Practice Address - Phone:470-242-1554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health