# KENAH ONE HEALTH CARE SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285255307
- **Authorized official:** KETTY NGONA CRNP, PMH-BC (PROGRAM DIRECTOR)
- **Authorized official phone:** (443) 465-9958

## Contact information

- **Practice address:** 308 CRAIN HWY N, GLEN BURNIE, MD 21061-3090
- **Practice address phone:** (443) 465-9958
- **Mailing address:** 7735 HOLLINS CHAPEL CT, GLEN BURNIE, MD 21060-8396
- **Mailing address phone:** (443) 465-9958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TR0400X | Rehabilitation Psychologist | — | NULL | — |
| 103TR0400X | Rehabilitation Psychologist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/29/2020
- **Last updated:** 11/29/2021