Provider Demographics
NPI:1659670842
Name:FIRST LEAP LLC
Entity type:Organization
Organization Name:FIRST LEAP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ALISON
Authorized Official - Last Name:KRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:512-887-2126
Mailing Address - Street 1:9901 N CAPITAL OF TEXAS HWY
Mailing Address - Street 2:#250
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5852
Mailing Address - Country:US
Mailing Address - Phone:512-887-2126
Mailing Address - Fax:512-949-5027
Practice Address - Street 1:9901 N CAPITAL OF TEXAS HWY
Practice Address - Street 2:#250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5852
Practice Address - Country:US
Practice Address - Phone:512-887-2126
Practice Address - Fax:512-949-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BCBA 01-06-3115252Y00000X
251S00000X, 251E00000X, 261QH0700X, 261QM0801X, 251C00000X, 225X00000X, 235Z00000X, 225XM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Multi-Specialty