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 ProprietorIntellectual Disabilities Residential Treatment Facility · COLUMBIA, SC
Registration Details
- NPI Number
- 1093393621
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 2, 2021 (5.0539202877695 yrs)
- Last Updated
- Apr 2, 2021
- License
-
27-0843094 (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
203 LONG RIDGE DRCOLUMBIA, SC, 292299284Browse SC providers · Browse ZIP 29229
- Phone
- 2152668158
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
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.