MEDICARE: PROFESSIONAL SERVICES OF HOLY CROSS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1114262938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL SERVICES OF HOLY CROSS

Provider Business Mailing Address
First Line	:	PO BOX 531863
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-1863
Country	:	US
Telephone Number	:	301-754-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	13415 CONNECTICUT AVE STE 100
Second Line	:
City	:	ASPEN HILL
State	:	MD
Zip	:	20906-2910
Country	:	US
Telephone Number	:	301-557-1950
Fax Number	:	301-557-1949

Authorized Official
Title or Position	:	VP AND CHIEF FINANCIAL OFFICER
Name	:	JULIE KEESE
Credential	:
Telephone Number	:	301-754-7201

Provider Enumeration Date	:	12/05/2012
Last Update Date	:	02/05/2026

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