Provider Demographics
NPI:1649890633
Name:LEA'S PLACE LLC
Entity type:Organization
Organization Name:LEA'S PLACE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEA
Authorized Official - Middle Name:
Authorized Official - Last Name:STERNBACH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:443-360-5527
Mailing Address - Street 1:6202 GIST AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3608
Mailing Address - Country:US
Mailing Address - Phone:410-292-8725
Mailing Address - Fax:
Practice Address - Street 1:1848 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1379
Practice Address - Country:US
Practice Address - Phone:443-360-5527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-20
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD07832OtherMBOTP (MARYLAND BOARD OF OCCUPATIONAL THERAPY PRACTICE