Kolmac Clinic LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

KOLMAC CLINIC LLC

Doing business as

Kolmac Outpatient Recovery Centers

Practice address

3905 National Dr Ste 200
Burtonsville, MD 20866-6143

Phone

(667) 239-3309

NPI assigned

Apr 22, 2020

Last updated

Oct 6, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

KOLMAC CLINIC LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keonna Armstrong

Title

VP RCM

Phone

(667) 239-3309

Specialties & licenses 1

Addresses

Other names 1

• Kolmac Outpatient Recovery Centers Doing business as

Tax ID family

Kolmac Clinic4 organizations share this tax ID, including this one

Part of

Kolmac Clinic

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Kolmac Clinic, LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Silver Spring, MD
  • NPI 1184638512
  NPD tax ID
• Kolmac Clinic, LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Towson, MD
  • NPI 1275155335
  NPD tax ID
• Kolmac Clinic, LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Arlington, VA
  • NPI 1346862562
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Kolmac Clinic, LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Silver Spring, MD
  • NPI 1184638512
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1215557038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 NATIONAL DR STE 200",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208666143",
            "telephone_number": "667-239-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 NATIONAL DR STE 200",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208666143",
            "telephone_number": "667-239-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOLMAC CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOLMAC CLINIC LLC",
        "enumeration_date": "2020-04-22",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "KEONNA",
        "authorized_official_title_or_position": "VP RCM",
        "authorized_official_telephone_number": "667-239-3309"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kolmac Outpatient Recovery Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kolmac Outpatient Recovery Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• King Awenate Khama
• Mary Ellen Killeen
• Hericc King
• Jordyn King
• Asha Kiyandur
• Michelle Koundou
• Brian Samuel Kressin, DPM
• Kelly C Kuhn, MPT
• Agnes Oben Etchi Kum
• Gabriel Kwekam

• Substance Use Disorder Rehabilitation Clinic/Center in Burtonsville, MD
• Providers in Burtonsville, MD by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.