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Organization

SPECTRUM OF HOPE-HEALTH WELLNESS AND COMMUNITY SERVICES

Active
Other names
Spectrum of Hope-Health Wellness and Community Services
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ABILA V TAZANU MD (MEDICAL DIRECTOR)
(301) 850-8955
Entity
Organization

Contact information

Practice address
5711 SARVIS AVE STE 100, RIVERDALE, MD 20737-1363
(301) 850-8955
(301) 882-9732
Mailing address
12303 STARLING LN, LAUREL, MD 20708-2835
(301) 957-1382

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008686000
MD
Enumeration date
12/03/2021
Last updated
02/01/2022
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