Healthcare Provider Details

I. General information

NPI: 1417764705
Provider Name (Legal Business Name): LEECAY CARE VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S ZANG BLVD STE 806
DALLAS TX
75208-6643
US

IV. Provider business mailing address

400 S ZANG BLVD STE 806
DALLAS TX
75208-6643
US

V. Phone/Fax

Practice location:
  • Phone: 469-342-1030
  • Fax:
Mailing address:
  • Phone: 469-342-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: GAELLE CAYO
Title or Position: CO-MEMBER
Credential:
Phone: 617-460-1702