Provider Demographics
NPI:1861015497
Name:LEADWAYS HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:LEADWAYS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OKIEMUTE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGHENEOCHUKOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-387-9911
Mailing Address - Street 1:2417 WELSH RD STE 21219
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2417 WELSH RD STE 21219
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2213
Practice Address - Country:US
Practice Address - Phone:347-387-9911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health