Provider Demographics
NPI:1952857799
Name:LEADING THERAPY HOME, LLC
Entity Type:Organization
Organization Name:LEADING THERAPY HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:STAR
Authorized Official - Last Name:O'DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:631-560-9970
Mailing Address - Street 1:61 LAURIE LN
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2714
Mailing Address - Country:US
Mailing Address - Phone:631-560-9970
Mailing Address - Fax:
Practice Address - Street 1:61 LAURIE LN
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2714
Practice Address - Country:US
Practice Address - Phone:631-560-9970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty