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General NPI Number Information
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NPI Number | 1972860583
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Entity Type | Organization
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Legal Business Name | KBC NURSING AGENCY AND HOME HEALTH CARE INC.
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 1915 RHODE ISLAND AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20018-2441
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Country | US
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Telephone | 202-636-1877
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Fax |
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Provider Business Mailing Address
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Address Line | 4607 DALLAS PL APT 204
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City | TEMPLE HILLS
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State | MD
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Zip | 20748-3321
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Country | US
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Telephone | 240-640-8513
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CHRISTINE WILLIAMS
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Credential |
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Telephone | 202-291-6973
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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 | J-250-048-089-430
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License Number State | MD
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