Provider Demographics
NPI:1003707126
Name:NEW LEAF RECREATION, LLC
Entity type:Organization
Organization Name:NEW LEAF RECREATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/RECREATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:STIEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-509-4697
Mailing Address - Street 1:104 E COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-5302
Mailing Address - Country:US
Mailing Address - Phone:260-267-5425
Mailing Address - Fax:
Practice Address - Street 1:104 E COLLINS RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-5302
Practice Address - Country:US
Practice Address - Phone:260-267-5425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty