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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LEROY BIBBS JR., MASTER'S DEGREE HUMA

Active Sole Proprietor

LEROY BIBBS JR., MASTER'S DEGREE HUMA is a Intellectual Disabilities Residential Treatment Facility healthcare provider located in COLUMBIA, South Carolina. NPI 1093393621 is currently active in the NPPES registry. Verify at CMS.

Intellectual Disabilities Residential Treatment Facility · COLUMBIA, SC

Registration Details

NPI Number
1093393621
Provider Type
Individual
Gender
Male
NPI Issued
Apr 2, 2021 (5.3762861970175 yrs)
Last Updated
Apr 2, 2021
License
27-0843094 (PA)
Sole Proprietor
Yes

Practice Information

Address
203 LONG RIDGE DR
COLUMBIA, SC, 292299284
Browse SC providers · Browse ZIP 29229
Phone
2152668158
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.