Organization
L.E.E.D.A. SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE A HORNBECK (BUSINESS MANAGER)
(330) 833-7993
Entity
Organization
Contact information
Practice address
1608 FOREST AVENUE SE, MASSILLON, OH 44647-6576
(330) 833-7993
(330) 833-7732
Mailing address
11 LINCOLN WAY W STE 5A, MASSILLON, OH 44647-6576
(330) 833-7993
(330) 833-7732
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0615034
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0615034
—
OH
Enumeration date
06/19/2007
Last updated
08/02/2007
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