Healthcare Provider Details

I. General information

NPI: 1164769659
Provider Name (Legal Business Name): ABC HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 N CAPITOL ST NW
WASHINGTON DC
20011-1416
US

IV. Provider business mailing address

6210 N CAPITOL ST NW
WASHINGTON DC
20011-1416
US

V. Phone/Fax

Practice location:
  • Phone: 202-215-5348
  • Fax:
Mailing address:
  • Phone: 202-215-5348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN M KAMYA
Title or Position: CEO
Credential:
Phone: 202-215-5348