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General NPI Number Information
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NPI Number | 1114726320
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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 | 03/10/2025
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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 |
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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 | 202-978-3794
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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 ISAAC NAZARETH
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Credential | BCBA
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Telephone | 771-201-9203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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