Healthcare Provider Details

I. General information

NPI: 1467286963
Provider Name (Legal Business Name): KCM CARES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 LOCKWOOD DR STE 160
SILVER SPRING MD
20901-1586
US

IV. Provider business mailing address

10801 LOCKWOOD DR STE 160
SILVER SPRING MD
20901-1586
US

V. Phone/Fax

Practice location:
  • Phone: 240-965-0229
  • Fax: 240-965-0052
Mailing address:
  • Phone: 240-965-0229
  • Fax: 240-965-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHRYN D KELLY
Title or Position: PRESIDENT
Credential: MD
Phone: 202-549-9557