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General NPI Number Information
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NPI Number | 1790163251
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Entity Type | Organization
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Legal Business Name | KEBROS & ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/15/2015
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 1604 SPRING HILL RD SUITE# 300
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City | VIENNA
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State | VA
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Zip | 22182-7510
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Country | US
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Telephone | 800-419-5343
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Fax | 240-455-4313
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Provider Business Mailing Address
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Address Line | 1604 SPRING HILL RD SUITE# 300
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City | VIENNA
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State | VA
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Zip | 22185-7510
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Country | US
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Telephone | 800-419-5343
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Fax | 240-455-4313
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ABIMBOLA EBODA
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Credential |
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Telephone | 800-419-5343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | VA
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