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Janice M. Leonard
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Longview, Texas
NPI 1689890592

Janice M. Leonard is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Longview, TX. Janice M. Leonard practices in Longview, TX. The NPI Number for Janice M. Leonard is 1689890592 and holds a License No. (Texas).

The current practice location address for Janice M. Leonard is 1413 W Loop 281 Ste 102, Longview, TX and can be reached out via phone at 903-297-0929 and via fax at 903-297-5345.

Location: 1413 W Loop 281 Ste 102, Longview, TX, 75604-2849
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1689890592
Provider Name
Janice M. Leonard
Credential
Provider Entity Type
Organization
Address
1413 W Loop 281 Ste 102, Longview, TX, 75604-2849
Phone Number
903-297-0929
Fax Number
903-297-5345
Provider Enumeration Date
04/18/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
001007923 01 TX CONTRACT # - DADS
88H 01 TX COMPONENT CODE - DADS
institution
Provider Business Practice Location Address Details
Address
1413 W Loop 281 Ste 102
City
Longview
State
Texas
Zip
75604-2849
Phone Number
903-297-0929
Fax Number
903-297-5345
person
Provider Business Mailing Address Details
Address
1413 W Loop 281 Ste 102
City
Longview
State
Texas
Zip
75604-2849
Phone Number
903-297-0929
Fax Number
903-297-5345
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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