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General NPI Number Information
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NPI Number | 1114711058
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Entity Type | Organization
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Legal Business Name | KIZA HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 5001 SEMINARY RD APT 305
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1907
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Country | US
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Telephone | 202-301-3913
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Fax | 301-204-6285
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Provider Business Mailing Address
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Address Line | 5001 SEMINARY RD APT 305
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1907
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Country | US
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Telephone | 202-301-3913
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JENIPHER I NAZARETH
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Credential | BCBA
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Telephone | 301-204-6285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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