Provider Demographics
NPI:1811592371
Name:LEADS
Entity Type:Organization
Organization Name:LEADS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:KEMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-258-6112
Mailing Address - Street 1:159 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-4921
Mailing Address - Country:US
Mailing Address - Phone:740-258-6112
Mailing Address - Fax:740-349-8087
Practice Address - Street 1:159 WILSON ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-4921
Practice Address - Country:US
Practice Address - Phone:740-258-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2090704OtherMEDICARE