| Kmdt Services Llc | |
|
8420 Dorsey Cir Manassas VA 20110-8300 | |
| (571) 279-8144 | |
| Not Available |
| Full Name | Kmdt Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8420 Dorsey Cir, Manassas, Virginia |
| Authorized Official Name and Position | Katharine Helene Mchugh (PRESIDENT) |
| Authorized Official Contact | 5712798144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kmdt Services Llc 7937 Flager Cir Manassas VA 20109-7437 Ph: (571) 279-8144 | Kmdt Services Llc 8420 Dorsey Cir Manassas VA 20110-8300 Ph: (571) 279-8144 |
| NPI Number | 1801269857 |
|---|---|
| Provider Enumeration Date | 11/12/2015 |
| Last Update Date | 11/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801269857 | NPI | - | NPPES |
| 004945247 | Medicaid | VA | |
| 020063P10 | Other | MEDICARE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0904007119 (Virginia) | Primary |
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