Provider Demographics
NPI:1447491253
Name:LEADQUEST THERAPY GROUP INC
Entity type:Organization
Organization Name:LEADQUEST THERAPY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEONILA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIMEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:626-307-1718
Mailing Address - Street 1:401 S GARFIELD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-3328
Mailing Address - Country:US
Mailing Address - Phone:626-307-1718
Mailing Address - Fax:626-307-1819
Practice Address - Street 1:401 S GARFIELD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-3328
Practice Address - Country:US
Practice Address - Phone:626-307-1718
Practice Address - Fax:626-307-1819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2044172993OtherEIN