Janice M. Leonard

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

JANICE M. LEONARD

Doing business as

Custom Care HCS

Practice address

1413 W Loop 281 Ste 102
Longview, TX 75604-2849

Phone

(903) 297-0929

Fax

(903) 297-5345

NPI assigned

Apr 18, 2007

Last updated

Jan 22, 2024By 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

Janice Wandrey Leonard

Title

Ceo / Program Manager

Phone

(903) 297-0929

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Custom Care HCS Doing business as

Locations

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1689890592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 W LOOP 281 STE 102",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042849",
            "telephone_number": "903-297-0929",
            "fax_number": "903-297-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W LOOP 281 STE 102",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042849",
            "telephone_number": "903-297-0929",
            "fax_number": "903-297-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANICE M. LEONARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "WANDREY",
        "authorized_official_title_or_position": "CEO / PROGRAM MANAGER",
        "authorized_official_telephone_number": "903-297-0929"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTRACT # - DADS",
            "identifier": "001007923",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPONENT CODE - DADS",
            "identifier": "88H",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Custom Care HCS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby James
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• Sarat Chandra Jampana, MD
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• Jared Jasicki
• Narasimha Sastry Jatavallabhula, MD
• Javen Valerie Cavazos MD PLLC
• David Jayakar, M.D.
• JD Medical Supplies, Inc.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Longview, TX
• Providers in Longview, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.