Provider Demographics
NPI:1770755027
Name:LEADING EDGE SERVICES INTERNATIONAL INC
Entity type:Organization
Organization Name:LEADING EDGE SERVICES INTERNATIONAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SOCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAAPHORST
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:504-468-6645
Mailing Address - Street 1:3715 WILLIAMS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3075
Mailing Address - Country:US
Mailing Address - Phone:504-468-6645
Mailing Address - Fax:504-468-6646
Practice Address - Street 1:3715 WILLIAMS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3075
Practice Address - Country:US
Practice Address - Phone:504-468-6645
Practice Address - Fax:504-468-6646
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEADING EDGE SERVICES INTERNATIONAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health