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NPI Code Detail

MEDICARE: XAVIER-KENSINGTON,LLC

MEDICARE: XAVIER-KENSINGTON,LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility15-017MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17100628OTHERMDEVERCARE

General Provider Information

NPI Number : 1902806268
Entity Type Code : Organization
Provider Name (Legal Business Name) : XAVIER-KENSINGTON,LLC
Provider Business Mailing Address
First Line : 3000 MCCOMAS AVE
Second Line :
City : KENSINGTON
State : MD
Zip : 20895-2316
Country : US
Telephone Number : 301-933-0060
Fax Number : 301-933-4884
Provider Business Practice Location Address
First Line : 3000 MCCOMAS AVE
Second Line :
City : KENSINGTON
State : MD
Zip : 20895-2316
Country : US
Telephone Number : 301-933-0060
Fax Number : 301-933-4884
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. DEE DESAI
Credential :
Telephone Number : 301-933-0060
Provider Enumeration Date : 07/28/2005
Last Update Date : 08/22/2020

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Directions to “XAVIER-KENSINGTON,LLC ” Practice Location

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