MEDICARE: LEADERSHIP HOME HEALTHCARE, LLC.

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	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1568031961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEADERSHIP HOME HEALTHCARE, LLC.

Provider Business Mailing Address
First Line	:	126 W LOGAN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-3620
Country	:	US
Telephone Number	:	267-625-5588
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 W LOGAN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-3620
Country	:	US
Telephone Number	:	267-625-5588
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JANELLE KIRKLAND
Credential	:
Telephone Number	:	267-625-5588

Provider Enumeration Date	:	06/21/2021
Last Update Date	:	06/21/2021

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