Healthcare Provider Details

I. General information

NPI: 1770168445
Provider Name (Legal Business Name): LEBLANC CLEANING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2021
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4612 S CARMINE
MESA AZ
85212-5139
US

IV. Provider business mailing address

4612 S CARMINE
MESA AZ
85212-5139
US

V. Phone/Fax

Practice location:
  • Phone: 480-721-0010
  • Fax:
Mailing address:
  • Phone: 480-721-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: BRIAN LEBLANC
Title or Position: OWNER
Credential:
Phone: 480-721-0010