Provider Demographics
NPI:1649511171
Name:LEAPS FORWARD, LLC
Entity type:Organization
Organization Name:LEAPS FORWARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-403-1332
Mailing Address - Street 1:3020 SATURN ST
Mailing Address - Street 2:#206
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821
Mailing Address - Country:US
Mailing Address - Phone:425-329-8788
Mailing Address - Fax:714-677-1785
Practice Address - Street 1:1819 REDMOND PL NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-3388
Practice Address - Country:US
Practice Address - Phone:206-214-7516
Practice Address - Fax:425-282-4168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health