Leidys Care Group Home Corp

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

LEIDYS CARE GROUP HOME CORP

Practice address

607 W Obispo Ave
Clewiston, FL 33440-4326

Phone

(863) 677-4189

NPI assigned

Feb 19, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leidys HerradaNPI 1609467836

Title

Business Owner

Phone

(863) 677-4189

Specialties & licenses 1

Addresses

Other names 1

• Leidys Care Group Home Corp Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leidys Herrada

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Clewiston, FL
  • NPI 1609467836

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1659964617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W OBISPO AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334404326",
            "telephone_number": "863-677-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W OBISPO AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334404326",
            "telephone_number": "863-677-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEIDYS CARE GROUP HOME CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "HERRADA",
        "authorized_official_first_name": "LEIDYS",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "863-677-4189"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leidys Care Group Home Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• A K Kaki, MD
• Haitham Kaki, RPH
• Leonardo Laguna Salvia
• Michelle Ann Langston, APRN
• Liana Leira Ledezma Reyes
• Boris Leyva Lopez, BCBA
• Jose R Llossas, R.D,L.D.
• Julio B Lopez, PA-C
• Pedro Loreto
• Laura Macias, LDO

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Clewiston, FL
• Providers in Clewiston, FL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.