Healthcare Provider Details

I. General information

NPI: 1386599629
Provider Name (Legal Business Name): CAROL HOMECARE AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 SPRINGRIDGE RD STE B
CLINTON MS
39056-5602
US

IV. Provider business mailing address

489 SPRINGRIDGE RD STE B
CLINTON MS
39056-5602
US

V. Phone/Fax

Practice location:
  • Phone: 601-914-5161
  • Fax: 601-914-3966
Mailing address:
  • Phone: 601-914-5161
  • Fax: 601-914-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. LESLIE C LEONARD
Title or Position: OWNER
Credential: PH.D.
Phone: 601-914-5161