Gold Leaf Enterprises Inc

Organization Active NPI Mental Health Counselor · Jackson, MO

NPI 1326200056 · NPPES record last updated Jun 25, 2008

Key facts

NPI
1326200056
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
License
214985 (MO)
Legal business name
GOLD LEAF ENTERPRISES INC
Practice address
1166 Greenway Dr
Suite B5
Jackson, MO 63755-2913
Phone
(573) 243-9900
Fax
(573) 243-5320
NPI assigned
Jun 25, 2008
Organization subpart
No

Authorized official

Name
Mrs. Sherri Gail Coomer
Title
President
Phone
(573) 243-9900

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Gold Leaf Enterprises Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101YM0800X 214985 MO Yes
Case Manager/Care Coordinator
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
171M00000X
Non-emergency Medical Transport (VAN) 343900000X 1706830 MO

Addresses

Primary practice location

1166 Greenway Dr
Suite B5
Jackson, MO 63755-2913

Mailing address

1166 Greenway Dr
Suite B5
Jackson, MO 63755-2913
Phone (573) 243-9900

Other providers in Jackson, MO

All providers in Jackson, MO · Mental Health Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.