Provider Demographics
NPI:1629946678
Name:LEADBETTER REHABILITATION, LLC
Entity type:Organization
Organization Name:LEADBETTER REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-651-0149
Mailing Address - Street 1:8420 GAS HOUSE PIKE STE U
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4974
Mailing Address - Country:US
Mailing Address - Phone:240-651-0149
Mailing Address - Fax:240-559-2624
Practice Address - Street 1:8927 FINGERBOARD RD STE A
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:MD
Practice Address - Zip Code:21704-8164
Practice Address - Country:US
Practice Address - Phone:240-651-0149
Practice Address - Fax:240-559-2624
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEADBETTER REHABILITATION, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty