Organization
SURVIVOR SOURCES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARSHALEE GEORGE (CHAIRMAN)
(443) 453-3343
Entity
Organization
Contact information
Practice address
4301 GARDEN CITY DR STE 304, HYATTSVILLE, MD 20785-6105
(301) 235-0060
Mailing address
4301 GARDEN CITY DR STE 304, HYATTSVILLE, MD 20785-6105
(301) 235-0060
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
—
Other
Enumeration date
11/30/2019
Last updated
11/13/2020
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