MEDICARE: KAHAK, INC.

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	251C00000X	Developmentally Disabled Services Day Training Agency
2	276400000X	Substance Use Disorder Rehabilitation Hospital Unit

General Provider Information

NPI Number	:	1386091478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAHAK, INC.

Provider Business Mailing Address
First Line	:	3831 PENNSYLVANIA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-1309
Country	:	US
Telephone Number	:	301-641-1514
Fax Number	:

Provider Business Practice Location Address
First Line	:	3831 PENNSYLVANIA AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-1309
Country	:	US
Telephone Number	:	301-641-1514
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHEL KAHAK
Credential	:
Telephone Number	:	301-641-1514

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	08/10/2023

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