Provider Demographics
NPI:1538437009
Name:KC COMMUNITY SERVICES INC
Entity type:Organization
Organization Name:KC COMMUNITY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-565-7624
Mailing Address - Street 1:2412 MINNESOTA AVE SE
Mailing Address - Street 2:UNIT A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5300
Mailing Address - Country:US
Mailing Address - Phone:202-957-7456
Mailing Address - Fax:202-747-7754
Practice Address - Street 1:2412 MINNESOTA AVE SE
Practice Address - Street 2:UNIT A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5300
Practice Address - Country:US
Practice Address - Phone:202-957-7456
Practice Address - Fax:202-747-7754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC042350200Medicaid