Organization
MALCOM GROW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRINA LYNN TAYOOR (SOCIAL WORKER)
(301) 808-5466
Entity
Organization
Contact information
Practice address
711 ROMFORD DR, HYATTSVILLE, MD 20785-5940
(301) 808-5466
Mailing address
503 SPECTATOR AVEUNE, LANDOVER, MD 20785
(301) 808-5466
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
612879
MD
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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