Leap of Faith Adult Services LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

LEAP OF FAITH ADULT SERVICES LLC

Practice address

528 Virginia Ave
Petersburg, VA 23803-5759

Phone

(804) 605-7883

NPI assigned

Sep 19, 2020

Last updated

Sep 19, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jessica Williams Booker, RN,BSN

Title

Program Director/QDDP/Owner

Phone

(804) 605-7883

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600473600000",
    "number": "1336755917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 TEAL CIR",
            "city": "NORTH DINWIDDIE",
            "state": "VA",
            "postal_code": "238036882",
            "telephone_number": "804-926-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 VIRGINIA AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035759",
            "telephone_number": "804-605-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAP OF FAITH ADULT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-19",
        "last_updated": "2020-09-19",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "BOOKER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "WILLIAMS",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR/QDDP/OWNER",
        "authorized_official_telephone_number": "804-605-7883",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN,BSN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki Y Lawrence Smith, PH.D
• David S Lawson
• Katherine Ann Laybourn, MD
• Lac K Le, M.D.
• Thu Le
• Shani Gabrielle Lee-Johnson, R.N.
• Ashley Jihui Lee
• Gernita Lazale Lee, D.N.P.
• Monterry Shatrae Lee
• Shayna Lee

• Developmentally Disabled Services Day Training Agency in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Developmentally Disabled Services Day Training Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.