MEDICARE: LEYCARE RESIDENTIAL SERVICES

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
1	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1427994177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEYCARE RESIDENTIAL SERVICES

Provider Business Mailing Address
First Line	:	10501 CHAMBERS DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2620
Country	:	US
Telephone Number	:	913-466-9556
Fax Number	:

Provider Business Practice Location Address
First Line	:	6017 N OLIVE AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5532
Country	:	US
Telephone Number	:	813-466-9556
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LEYLA RAMONA MAYSONET
Credential	:
Telephone Number	:	813-466-9556

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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