PROVIDENCE CARE INC NPI 1245376375

NPI Information

NPI: 1245376375
Provider Name: PROVIDENCE CARE INC
Classification: Clinic/Center - 261QD1600X
Specialization: Developmental Disabilities
Entity Type: Organization
Address: 5711 SARVIS AVE STE 608
RIVERDALE, MD
ZIP 20737
Phone: (301) 277-4337

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NPI Details

PROVIDENCE CARE INC is a developmental disabilities clinic center in Riverdale, MD. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). PROVIDENCE CARE INC NPI is 1245376375. The provider is registered as an organization entity type.

The provider's business location address is:

5711 SARVIS AVE STE 608
RIVERDALE, MD
ZIP 20737-394
Phone: (301) 277-4337

The provider's authorized official is Guillaume Sery Kabert .
The authorized official title is Owner/ceo and has the following contact phone number (301) 277-4337.

The enumeration date for this NPI number is 1/29/2007 and was last updated on 11/26/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251J00000X	Nursing Care				No
2	261QD1600X	Clinic/Center	Developmental Disabilities			Yes
3	253Z00000X	In Home Supportive Care		039714600	DISTRICT OF COLUMBIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	405870400	MEDICAID	MARYLAND
2	1245376375	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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