Provider Demographics
NPI:1023827110
Name:LEELIA'S HEALTHCARE
Entity type:Organization
Organization Name:LEELIA'S HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MISS
Authorized Official - First Name:RAFIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-253-1767
Mailing Address - Street 1:8670 SPUR LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-1206
Mailing Address - Country:US
Mailing Address - Phone:410-253-1767
Mailing Address - Fax:
Practice Address - Street 1:8670 SPUR LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-1206
Practice Address - Country:US
Practice Address - Phone:410-253-1767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service