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Leroy Bibbs JR., MASTER'SDEGREEHUMA
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Columbia, South Carolina
NPI 1093393621

Leroy Bibbs JR. is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Columbia, SC. Leroy Bibbs JR. practices in Columbia, SC and has the professional credentials of MASTER'SDEGREEHUMA. The NPI Number for Leroy Bibbs JR. is 1093393621 and holds a License No. 27-0843094 (South Carolina).

The current practice location address for Leroy Bibbs JR. is 203 Long Ridge Dr, Columbia, SC and can be reached out via phone at 215-266-8158.

Location: 203 Long Ridge Dr, Columbia, SC, 29229-9284
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093393621
Provider Name
Leroy Bibbs JR.
Credential
MASTER'SDEGREEHUMA
Provider Entity Type
Individual
Gender
Male
Address
203 Long Ridge Dr, Columbia, SC, 29229-9284
Phone Number
215-266-8158
Fax Number
Provider Enumeration Date
04/02/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
203 Long Ridge Dr
City
Columbia
State
South Carolina
Zip
29229-9284
Phone Number
215-266-8158
Fax Number
person
Provider Business Mailing Address Details
Address
203 Long Ridge Dr
City
Columbia
State
South Carolina
Zip
29229-9284
Phone Number
215-266-8158
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
27-0843094 (Pennsylvania)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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