Healthcare Provider Details

I. General information

NPI: 1801625710
Provider Name (Legal Business Name): KAIROS HEALTHCARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 H ST NE STE 305
WASHINGTON DC
20002-7184
US

IV. Provider business mailing address

10601 BIRDIE LN
UPPER MARLBORO MD
20774-6022
US

V. Phone/Fax

Practice location:
  • Phone: 301-272-5016
  • Fax:
Mailing address:
  • Phone: 301-272-5016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GODWIN IGBO
Title or Position: PRESIDENT
Credential:
Phone: 240-455-8954