Organization
LEIDYS CARE GROUP HOME CORP
Active
Other names
Leidys Care Group Home Corp
Organization subpart
No
Provider details
NPI number
Authorized official
LEIDYS HERRADA (BUSINESS OWNER)
(863) 677-4189
Entity
Organization
Contact information
Practice address
607 W OBISPO AVE, CLEWISTON, FL 33440-4326
(863) 677-4189
Mailing address
607 W OBISPO AVE, CLEWISTON, FL 33440-4326
(863) 677-4189
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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