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General NPI Number Information
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NPI Number | 1447808464
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Entity Type | Organization
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Legal Business Name | KMAC'S FAMILY CAREGIVERS, LLC
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 6713 BURCH HILL RD STE A
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City | BRANDYWINE
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State | MD
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Zip | 20613-9093
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Country | US
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Telephone | 301-501-5010
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Fax |
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Provider Business Mailing Address
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Address Line | 6713 BURCH HILL RD
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City | BRANDYWINE
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State | MD
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Zip | 20613-9093
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO/ VICE PRESIDENT
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Name | KHALIL MOODY
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Credential |
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Telephone | 301-661-2699
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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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