Provider Demographics
NPI:1447885223
Name:KB HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:KB HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KWAKU
Authorized Official - Middle Name:
Authorized Official - Last Name:BOATENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-274-0444
Mailing Address - Street 1:462 HERNDON PKWY STE 206
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5235
Mailing Address - Country:US
Mailing Address - Phone:571-274-0444
Mailing Address - Fax:703-552-7676
Practice Address - Street 1:462 HERNDON PKWY STE 206
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5235
Practice Address - Country:US
Practice Address - Phone:571-274-0444
Practice Address - Fax:703-552-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-11
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health