Provider Demographics
NPI:1821337866
Name:LEANN CARE LLC
Entity Type:Organization
Organization Name:LEANN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:LYNNIASE
Authorized Official - Last Name:MCGOUGHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-506-9222
Mailing Address - Street 1:33 RAWLINGWOOD CV
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-8580
Mailing Address - Country:US
Mailing Address - Phone:731-506-9222
Mailing Address - Fax:731-506-3580
Practice Address - Street 1:33 RAWLIG WOOD COVE AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305
Practice Address - Country:US
Practice Address - Phone:731-506-9222
Practice Address - Fax:731-506-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3104A0625X3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness