Provider Demographics
NPI:1023430048
Name:LEILA
Entity type:Organization
Organization Name:LEILA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:330-524-7789
Mailing Address - Street 1:1666 11TH ST
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-4514
Mailing Address - Country:US
Mailing Address - Phone:330-524-7789
Mailing Address - Fax:
Practice Address - Street 1:1666 11TH ST
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-4514
Practice Address - Country:US
Practice Address - Phone:330-524-7789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05618261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation