Provider Demographics
NPI:1609008747
Name:LEOAN, INC.
Entity Type:Organization
Organization Name:LEOAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEONOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SIFREDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-644-9621
Mailing Address - Street 1:2028 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3404
Mailing Address - Country:US
Mailing Address - Phone:305-644-9621
Mailing Address - Fax:
Practice Address - Street 1:2028 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3404
Practice Address - Country:US
Practice Address - Phone:305-644-9621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL87703104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness