Healthcare Provider Details

I. General information

NPI: 1811697725
Provider Name (Legal Business Name): KABIR HEATH & COMMUNITY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6564 LOISDALE CT STE 600D
SPRINGFIELD VA
22150-1838
US

IV. Provider business mailing address

6564 LOISDALE CT STE 600D6564
SPRINGFIELD VA
22150-1827
US

V. Phone/Fax

Practice location:
  • Phone: 240-486-7038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KHADIJA BAMBAY JALLOH
Title or Position: MANAGER
Credential:
Phone: 703-459-9722