Healthcare Provider Details

I. General information

NPI: 1679437180
Provider Name (Legal Business Name): PROFESSIONAL SERVICES OF HOLY CROSS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 HARRY S TRUMAN DR N
LARGO MD
20774-5477
US

IV. Provider business mailing address

PO BOX 531863
ATLANTA GA
30353-1863
US

V. Phone/Fax

Practice location:
  • Phone: 301-557-6000
  • Fax:
Mailing address:
  • Phone: 301-557-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE KEESE
Title or Position: VP, FINANCE AND CFO
Credential:
Phone: 301-754-7201