Provider Demographics
NPI:1518850809
Name:LEO HOMECARE WELLNESS LLC
Entity type:Organization
Organization Name:LEO HOMECARE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:KEMUNTO
Authorized Official - Last Name:SOKOMWUYOH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:763-746-6701
Mailing Address - Street 1:9368 28TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-5703
Mailing Address - Country:US
Mailing Address - Phone:763-746-6701
Mailing Address - Fax:
Practice Address - Street 1:9368 28TH ST NE
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:MN
Practice Address - Zip Code:55376-5703
Practice Address - Country:US
Practice Address - Phone:763-746-6701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center