Provider Demographics
NPI:1609461888
Name:LESDELICES LLC
Entity Type:Organization
Organization Name:LESDELICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:DELICES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-686-5614
Mailing Address - Street 1:7905 BRETHREN DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-5640
Mailing Address - Country:US
Mailing Address - Phone:240-686-5614
Mailing Address - Fax:
Practice Address - Street 1:7905 BRETHREN DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-5640
Practice Address - Country:US
Practice Address - Phone:240-686-5614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty