MEDICARE: KALONI KAYLA WASHINGTON

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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1255203261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALONI KAYLA WASHINGTON

Provider Business Mailing Address
First Line	:	2155 BEECHER RD SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-2507
Country	:	US
Telephone Number	:	336-287-8421
Fax Number	:

Provider Business Practice Location Address
First Line	:	2155 BEECHER RD SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-2507
Country	:	US
Telephone Number	:	336-287-8421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2025
Last Update Date	:	09/20/2025

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