Provider Demographics
NPI:1477337582
Name:LEAP WITH FAITH HOMECARE, LLC
Entity Type:Organization
Organization Name:LEAP WITH FAITH HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AKISSI
Authorized Official - Middle Name:
Authorized Official - Last Name:OUSSOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-430-0640
Mailing Address - Street 1:5224 WESTFORD RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-3619
Mailing Address - Country:US
Mailing Address - Phone:347-430-0640
Mailing Address - Fax:
Practice Address - Street 1:5224 WESTFORD RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-3619
Practice Address - Country:US
Practice Address - Phone:347-430-0640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care