Provider Demographics
NPI:1639550734
Name:GREAT LEAPS LEARNING CENTER
Entity type:Organization
Organization Name:GREAT LEAPS LEARNING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:BICARD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA-D, LBA
Authorized Official - Phone:334-595-3673
Mailing Address - Street 1:120 MELISON DR
Mailing Address - Street 2:
Mailing Address - City:PIKE ROAD
Mailing Address - State:AL
Mailing Address - Zip Code:36064-2555
Mailing Address - Country:US
Mailing Address - Phone:334-595-3673
Mailing Address - Fax:
Practice Address - Street 1:120 MELISON DR
Practice Address - Street 2:
Practice Address - City:PIKE ROAD
Practice Address - State:AL
Practice Address - Zip Code:36064-2555
Practice Address - Country:US
Practice Address - Phone:334-595-3673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency