NPI 1093393621

Leroy Bibbs, MASTERSDEGREEHUMA

Practitioner Intellectual and/or Developmental Disabilities Residential Treatment Facility Columbia, SC

Practice location

Address: 203 Long Ridge Dr, Columbia, SC 29229-9284
Phone: (215) 266-8158

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 27-0843094 (PA)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in South Carolina →

Registry record

NPI: 1093393621
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Apr 2021
Record last updated: 2 Apr 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.