| Gold Leaf Enterprises, Inc | |
|
1166 Greenway Dr Ste B5 Jackson MO 63755-2921 | |
| (573) 866-9900 | |
| Not Available |
| Full Name | Gold Leaf Enterprises, Inc |
|---|---|
| Speciality | Counselor |
| Location | 1166 Greenway Dr Ste B5, Jackson, Missouri |
| Authorized Official Name and Position | Sherri G Coomer (PRESIDENT) |
| Authorized Official Contact | 5732439900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gold Leaf Enterprises, Inc 1166 Greenway Dr Ste B5 Jackson MO 63755-2921 Ph: (573) 866-9900 | Gold Leaf Enterprises, Inc 1166 Greenway Dr Ste B5 Jackson MO 63755-2921 Ph: (573) 866-9900 |
| NPI Number | 1861674350 |
|---|---|
| Provider Enumeration Date | 11/27/2007 |
| Last Update Date | 11/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861674350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Missouri) | Primary |
| 343900000X | Non-emergency Medical Transport (van) | (Missouri) | Secondary |
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