Healthcare Provider Details

I. General information

NPI: 1275159212
Provider Name (Legal Business Name): KLI NURSING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7206 25TH AVE
ADELPHI MD
20783-2751
US

IV. Provider business mailing address

7206 25TH AVE
ADELPHI MD
20783-2751
US

V. Phone/Fax

Practice location:
  • Phone: 240-281-3574
  • Fax: 301-273-3543
Mailing address:
  • Phone: 240-281-3574
  • Fax: 301-273-3543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LOVINNA ONYEJIAKA
Title or Position: REGISTERED NURSE
Credential: ADMINISTRATOR
Phone: 240-281-3574