Provider Demographics
NPI:1629478565
Name:LEASE A MOM
Entity Type:Organization
Organization Name:LEASE A MOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:ENO
Authorized Official - Last Name:BARNABY
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MA; CMT
Authorized Official - Phone:301-802-5181
Mailing Address - Street 1:9403 GENTLE CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-1206
Mailing Address - Country:US
Mailing Address - Phone:301-802-5181
Mailing Address - Fax:
Practice Address - Street 1:9403 GENTLE CIR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-1206
Practice Address - Country:US
Practice Address - Phone:301-802-5181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health