Provider Demographics
NPI:1689731879
Name:LEAPS AND BOUNDS SPEECH SERVICES, INC.
Entity Type:Organization
Organization Name:LEAPS AND BOUNDS SPEECH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HELGESON
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCCSLP
Authorized Official - Phone:701-356-0062
Mailing Address - Street 1:PO BOX 761
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-0761
Mailing Address - Country:US
Mailing Address - Phone:701-356-0062
Mailing Address - Fax:701-356-5412
Practice Address - Street 1:1207 PRAIRIE PKWY
Practice Address - Street 2:STE. A
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3145
Practice Address - Country:US
Practice Address - Phone:701-356-0062
Practice Address - Fax:701-356-5412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND56111Medicaid