| Kaleidoscope Wellness And Education Group Llc | |
|
14935 Nighthawk Ln Bowie MD 20716-1036 | |
| (301) 202-4353 | |
| Not Available |
| Full Name | Kaleidoscope Wellness And Education Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14935 Nighthawk Ln, Bowie, Maryland |
| Authorized Official Name and Position | Kenya Coleman (OWNER) |
| Authorized Official Contact | 3012024353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaleidoscope Wellness And Education Group Llc 14935 Nighthawk Ln Bowie MD 20716-1036 Ph: (301) 202-4353 | Kaleidoscope Wellness And Education Group Llc 14935 Nighthawk Ln Bowie MD 20716-1036 Ph: (301) 202-4353 |
| NPI Number | 1669161782 |
|---|---|
| Provider Enumeration Date | 05/04/2023 |
| Last Update Date | 09/28/2023 |
| Certification Date | 09/28/2023 |
| Medicare PECOS PAC ID | 7911359849 |
|---|---|
| Medicare Enrollment ID | O20240117000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669161782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kenya Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578679635 PECOS PAC ID: 4385743988 Enrollment ID: I20070723000714 |
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