Provider Demographics
NPI:1942619119
Name:LEEDS HEALTHCARE LLC
Entity Type:Organization
Organization Name:LEEDS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:YEWANDE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLANIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-219-8369
Mailing Address - Street 1:9903 GLENKIRK WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2984
Mailing Address - Country:US
Mailing Address - Phone:301-219-8369
Mailing Address - Fax:
Practice Address - Street 1:9903 GLENKIRK WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2984
Practice Address - Country:US
Practice Address - Phone:301-219-8369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR183989253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care