Healthcare Provider Details

I. General information

NPI: 1275893356
Provider Name (Legal Business Name): KBC NURSING AGENCY AND HOME HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 05/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9141 LANHAM SEVERN RD
LANHAM MD
20706-2915
US

IV. Provider business mailing address

9141 LANHAM SEVERN RD
LANHAM MD
20706-2915
US

V. Phone/Fax

Practice location:
  • Phone: 301-281-3207
  • Fax:
Mailing address:
  • Phone: 301-281-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTINE WILLIAMS
Title or Position: SUPERVISOR
Credential:
Phone: 202-291-6973