Organization
KELLYS SUPPORT SERVICES OF MARYLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ANYE MIYANG (EXECUTIVE DURECTOR)
(919) 444-1550
Entity
Organization
Contact information
Practice address
3920 ROCK SPRING DR, UPPER MARLBORO, MD 20772-3993
(919) 444-1550
Mailing address
3920 ROCK SPRING DR, UPPER MARLBORO, MD 20772-3993
(919) 444-1550
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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