Provider Demographics
NPI:1003562562
Name:LEELI HEALTH CARE LLC
Entity Type:Organization
Organization Name:LEELI HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MULBAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-274-3648
Mailing Address - Street 1:7601 ALDRICH AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55444-2544
Mailing Address - Country:US
Mailing Address - Phone:651-300-4971
Mailing Address - Fax:763-207-1573
Practice Address - Street 1:7601 ALDRICH AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55444-2544
Practice Address - Country:US
Practice Address - Phone:651-300-4971
Practice Address - Fax:763-207-1573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility