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NPI Code Detail

MEDICARE: LEEDA NORTHEAST, INC.

MEDICARE: LEEDA NORTHEAST, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency
2261QA0600XAdult Day Care Clinic/Center
3251C00000XDevelopmentally Disabled Services Day Training Agency
4343900000XNon-emergency Medical Transport (VAN)
5251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255959557
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEEDA NORTHEAST, INC.
Provider Business Mailing Address
First Line : 1441 PARKMAN RD NW
Second Line :
City : WARREN
State : OH
Zip : 44485-2156
Country : US
Telephone Number : 330-392-6006
Fax Number : 330-392-6116
Provider Business Practice Location Address
First Line : 1441 PARKMAN RD NW
Second Line :
City : WARREN
State : OH
Zip : 44485-2156
Country : US
Telephone Number : 330-392-6006
Fax Number : 330-392-6116
Authorized Official
Title or Position : ADMINISTRATOR DESIGNEE
Name : MEGAN SWEENEY
Credential :
Telephone Number : 330-392-6006
Provider Enumeration Date : 07/13/2020
Last Update Date : 09/22/2020

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Directions to “LEEDA NORTHEAST, INC. ” Practice Location

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