Provider Demographics
NPI:1558468157
Name:LEONE HOMEHEALTH CARE AGENCY INC.
Entity type:Organization
Organization Name:LEONE HOMEHEALTH CARE AGENCY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALIE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:KOROMA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-227-2510
Mailing Address - Street 1:3334 BROADWAY BLVD STE 422
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1575
Mailing Address - Country:US
Mailing Address - Phone:214-227-2510
Mailing Address - Fax:214-227-2410
Practice Address - Street 1:3334 BROADWAY BLVD STE 422
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1575
Practice Address - Country:US
Practice Address - Phone:214-227-2510
Practice Address - Fax:214-227-2410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-18
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2172884-01Medicaid