Healthcare Provider Details

I. General information

NPI: 1740125152
Provider Name (Legal Business Name): SAINT GABRIEL HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/02/2026
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: 877-408-0066
Mailing address:
  • Phone: 301-814-0037
  • Fax: 877-408-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: GLENNA L KWAME-GREENE
Title or Position: ADMINISTRATOR
Credential: MBA,BSN
Phone: 301-814-0037