| Kairos Center Maryland, Inc | |
|
4041 7th St North Beach MD 20714-5029 | |
| (301) 332-4568 | |
| (202) 315-3417 |
| Full Name | Kairos Center Maryland, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4041 7th St, North Beach, Maryland |
| Authorized Official Name and Position | Carolyn Janet Hansen (DIRECTOR) |
| Authorized Official Contact | 3013324568 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kairos Center Maryland, Inc Po Box 25 North Beach MD 20714-0025 Ph: (301) 332-4568 | Kairos Center Maryland, Inc 4041 7th St North Beach MD 20714-5029 Ph: (301) 332-4568 |
| NPI Number | 1750856555 |
|---|---|
| Provider Enumeration Date | 10/08/2018 |
| Last Update Date | 03/06/2019 |
| Medicare PECOS PAC ID | 2769719962 |
|---|---|
| Medicare Enrollment ID | O20190812000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750856555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Carolyn J Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285806240 PECOS PAC ID: 5698952125 Enrollment ID: I20110608000782 |
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