MEDICARE: KBC NURSING AGENCY HM HEALTH INC

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	385H00000X	Respite Care
3	251E00000X	Home Health Agency	65003496	DC

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1376694869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KBC NURSING AGENCY HM HEALTH INC

Provider Business Mailing Address
First Line	:	7506 GEORGIA AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1608
Country	:	US
Telephone Number	:	202-291-6973
Fax Number	:

Provider Business Practice Location Address
First Line	:	7506 GEORGIA AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1608
Country	:	US
Telephone Number	:	202-291-6973
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. CHRISTINE N WILLIAMS
Credential	:	MBPA, RN
Telephone Number	:	202-291-6973

Provider Enumeration Date	:	01/13/2007
Last Update Date	:	03/28/2022

7530 GEORGIA AVE NW
WASHINGTON, DC
20012-1608

Practice Phone: 202-722-2224
Practice Fax: 202-291-8266