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General NPI Number Information
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NPI Number | 1194676221
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Entity Type | Organization
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Legal Business Name | LESLIE'S HOUSE LLC
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 4312 BERGER AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-3649
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Country | US
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Telephone | 443-909-1307
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Fax | 443-909-1306
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Provider Business Mailing Address
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Address Line | 4709 HARFORD RD STE 42
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City | BALTIMORE
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State | MD
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Zip | 21214-3205
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Country | US
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Telephone | 443-909-1307
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Fax | 443-909-1306
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | BERNADETTE KENNARD
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Credential |
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Telephone | 443-909-1307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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