Provider Demographics
NPI:1225277858
Name:LEVERIDGE HOME CARE AGENCY INC
Entity Type:Organization
Organization Name:LEVERIDGE HOME CARE AGENCY INC
Other - Org Name:EMPLOYMENT AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:CECELIA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-284-0871
Mailing Address - Street 1:723 ROGERS AVE
Mailing Address - Street 2:723
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-2504
Mailing Address - Country:US
Mailing Address - Phone:718-284-0871
Mailing Address - Fax:718-284-2316
Practice Address - Street 1:723 ROGERS AVE
Practice Address - Street 2:723
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-2504
Practice Address - Country:US
Practice Address - Phone:718-284-0871
Practice Address - Fax:718-284-2316
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1307L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health