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General NPI Number Information
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NPI Number | 1346197076
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Entity Type | Organization
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Legal Business Name | JEANETTES HOUSE LLC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 510 CARROLL WALK AVE
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City | FREDERICK
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State | MD
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Zip | 21701-6943
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Country | US
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Telephone | 240-936-0993
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Fax |
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Provider Business Mailing Address
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Address Line | 22108 WINDING WOODS WAY
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City | CLARKSBURG
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State | MD
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Zip | 20871-6366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ADELAIDE ABANKWAH
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Credential |
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Telephone | 301-765-4798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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