Provider Demographics
NPI:1578015038
Name:LEANDER HOUSE, INC.
Entity Type:Organization
Organization Name:LEANDER HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-528-8491
Mailing Address - Street 1:48 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1812
Mailing Address - Country:US
Mailing Address - Phone:413-528-8491
Mailing Address - Fax:732-474-9417
Practice Address - Street 1:48 WEST AVE
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1812
Practice Address - Country:US
Practice Address - Phone:413-528-8491
Practice Address - Fax:732-474-9417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200564320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities