Provider Demographics
NPI:1760751291
Name:LOVING LEAPS, INC
Entity Type:Organization
Organization Name:LOVING LEAPS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LISSA
Authorized Official - Middle Name:DONELL
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:214-801-9070
Mailing Address - Street 1:4830 CEDAR SPRINGS RD APT 34
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1365
Mailing Address - Country:US
Mailing Address - Phone:214-801-9070
Mailing Address - Fax:972-664-0507
Practice Address - Street 1:4830 CEDAR SPRINGS RD APT 34
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-1365
Practice Address - Country:US
Practice Address - Phone:214-801-9070
Practice Address - Fax:972-664-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty