Healthcare Provider Details

I. General information

NPI: 1730022922
Provider Name (Legal Business Name): SAINT GABRIEL HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11402 COVERED BRIDGE CT
GLENN DALE MD
20769-9130
US

IV. Provider business mailing address

11402 COVERED BRIDGE CT
GLENN DALE MD
20769-9130
US

V. Phone/Fax

Practice location:
  • Phone: 301-814-0037
  • Fax:
Mailing address:
  • Phone: 301-814-0037
  • Fax: 877-408-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: GLENNA L KWAME-GREENE
Title or Position: OWNER
Credential:
Phone: 301-814-0037