Healthcare Provider Details

I. General information

NPI: 1003721309
Provider Name (Legal Business Name): SABINAS HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3631 ERDMAN AVE
BALTIMORE MD
21213-1941
US

IV. Provider business mailing address

435 EASTERN BLVD STE C
ESSEX MD
21221-6715
US

V. Phone/Fax

Practice location:
  • Phone: 443-596-8238
  • Fax: 443-505-8815
Mailing address:
  • Phone: 443-596-8238
  • Fax: 443-505-8815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DONALD KENNARD
Title or Position: VP, DIRECTOR OF OPERATIONS
Credential:
Phone: 443-596-8238