Provider Demographics
NPI:1588438196
Name:KAIROS EMBRACE BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:KAIROS EMBRACE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENIA
Authorized Official - Middle Name:OGEH
Authorized Official - Last Name:CATERNOR
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,CRNP, PMHNP
Authorized Official - Phone:443-356-0007
Mailing Address - Street 1:14300 CHERRY LANE CT STE 108
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4978
Mailing Address - Country:US
Mailing Address - Phone:443-356-0007
Mailing Address - Fax:443-884-5567
Practice Address - Street 1:14300 CHERRY LANE CT STE 108
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4978
Practice Address - Country:US
Practice Address - Phone:443-356-0007
Practice Address - Fax:443-884-5567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty