MEDICARE: ABAH-KROSS HEALTHCARE SERVICES, LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356924906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABAH-KROSS HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	6000 PRINCESS GARDEN PKWY
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-2907
Country	:	US
Telephone Number	:	301-641-3579
Fax Number	:	301-679-7090

Provider Business Practice Location Address
First Line	:	6000 PRINCESS GARDEN PKWY
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-2907
Country	:	US
Telephone Number	:	301-641-3579
Fax Number	:	301-679-7090

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	OLABIMITAN DANIELS
Credential	:
Telephone Number	:	301-641-3579

Provider Enumeration Date	:	05/02/2021
Last Update Date	:	05/02/2021

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