| Khi Services, Inc. | |
|
19530 Doctors Dr Germantown MD 20874-5200 | |
| (240) 686-0707 | |
| (240) 686-0711 |
| Full Name | Khi Services, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 19530 Doctors Dr, Germantown, Maryland |
| Authorized Official Name and Position | Roger Dean Larson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2406860707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Khi Services, Inc. 19530 Doctors Dr Germantown MD 20874-5200 Ph: (240) 686-0707 | Khi Services, Inc. 19530 Doctors Dr Germantown MD 20874-5200 Ph: (240) 686-0707 |
| NPI Number | 1376861013 |
|---|---|
| Provider Enumeration Date | 05/05/2010 |
| Last Update Date | 05/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376861013 | NPI | - | NPPES |
| 258905200 | Medicaid | MD | |
| 481107100 | Medicaid | MD | |
| 801602000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 461 (Maryland) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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