Provider Demographics
NPI:1912103433
Name:L.E.E.D.A. SERVICES, INC.
Entity Type:Organization
Organization Name:L.E.E.D.A. SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HORNBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-833-7993
Mailing Address - Street 1:11 LINCOLN WAY W
Mailing Address - Street 2:5A
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-6585
Mailing Address - Country:US
Mailing Address - Phone:330-833-7993
Mailing Address - Fax:330-833-7732
Practice Address - Street 1:1620 FOREST AVENUE SE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647
Practice Address - Country:US
Practice Address - Phone:330-833-7993
Practice Address - Fax:330-833-7732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0615043315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities