Provider Demographics
NPI:1992586051
Name:BUCKLEAF HOME CARE LLC
Entity type:Organization
Organization Name:BUCKLEAF HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-389-4925
Mailing Address - Street 1:1860 SW FOUNTAINVIEW BLVD STE 85
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4535
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1860 SW FOUNTAINVIEW BLVD STE 85
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4535
Practice Address - Country:US
Practice Address - Phone:305-389-4925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care