| Lead 4 Life, Inc. | |
|
100 Clemwood St Salisbury MD 21804-6489 | |
| (443) 978-7864 | |
| (443) 859-8880 |
| Full Name | Lead 4 Life, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 Clemwood St, Salisbury, Maryland |
| Authorized Official Name and Position | Tamara Denise Reynolds (OFFICE MANAGER) |
| Authorized Official Contact | 4439787864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lead 4 Life, Inc. 2096 Gaither Rd Ste 110 Rockville MD 20850-4027 Ph: (301) 672-4319 | Lead 4 Life, Inc. 100 Clemwood St Salisbury MD 21804-6489 Ph: (443) 978-7864 |
| NPI Number | 1215689294 |
|---|---|
| Provider Enumeration Date | 01/21/2022 |
| Last Update Date | 01/21/2022 |
| Certification Date | 01/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215689294 | NPI | - | NPPES |
| 201507201 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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