Provider Demographics
NPI:1003690322
Name:K&I HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:K&I HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:OBIORA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:240-667-1679
Mailing Address - Street 1:11637 TERRACE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3708
Mailing Address - Country:US
Mailing Address - Phone:240-419-3803
Mailing Address - Fax:240-419-2931
Practice Address - Street 1:4301 GARDEN CITY DR STE 303
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-6105
Practice Address - Country:US
Practice Address - Phone:240-667-1679
Practice Address - Fax:240-667-1712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility