Provider Demographics
NPI:1225870546
Name:KAHAK MD, INC.
Entity type:Organization
Organization Name:KAHAK MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-722-1700
Mailing Address - Street 1:12501 PROSPERITY DR STE 315
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1689
Mailing Address - Country:US
Mailing Address - Phone:301-641-1514
Mailing Address - Fax:
Practice Address - Street 1:9771 TIGER LILY PATH APT 1D
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-6344
Practice Address - Country:US
Practice Address - Phone:301-641-1514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities