Provider Demographics
NPI:1265792337
Name:LEADER'S PRIMARY HOME CARE, LLC
Entity type:Organization
Organization Name:LEADER'S PRIMARY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-962-9049
Mailing Address - Street 1:9140 HIGHWAY 6 NORTH APT 910
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-2489
Mailing Address - Country:US
Mailing Address - Phone:713-962-9049
Mailing Address - Fax:
Practice Address - Street 1:9140 HIGHWAY 6 NORTH APT 910
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095
Practice Address - Country:US
Practice Address - Phone:713-962-9049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health