SURVIVOR SOURCES INC (NPI# 1174160980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174160980 |
| Entity Type | Organization |
| Organization Name | SURVIVOR SOURCES INC |
| Practice Address |
6305 Ivy Ln Ste 101 Greenbelt MD 20770-6326 |
| Practice Telephone | 3015606220 |
| Mailing Telephone | 3015606220 |
| Enumeration Date | 2019-11-30 |
| Last Update Date | 2019-11-30 |
| Authorized Official Name | DR. MARSHALEE GEORGE (CHAIRMAN) |
| Authorized Official Telephone | 4434533343 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SURVIVOR SOURCES INC | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 |
| Street Address |
6305 IVY LN STE 101 |
| City | GREENBELT |
| State | MD |
| Zip Code | 20770-6326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508827809 | Bernadette Assumpta Bangnam | Registered Nurse | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2006-03-28 |
| 1225643000 | Advanced Healthcare and Allied Services, LLC | Community/Behavioral Health | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2020-09-09 |
| 1255945242 | Advanced Healthcare and Allied Services, LLC | Nurse Practitioner | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2020-09-07 |
| 1356907844 | Peter Devlin | Social Worker | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2019-05-10 |
| 1972166163 | Advanced Healthcare & Allied Services, Inc. | Home Health | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2019-04-15 |
| 1760966436 | Akos Antwi | Registered Nurse | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-09-19 |
| 1114420320 | Wellness Source LLC | Dietitian, Registered | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-03-14 |
| 1205339413 | Wellness Source LLC | Social Worker | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-03-14 |
| 1619477478 | Divya Lakshmi Selvakumar | Dietitian, Registered | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-6326 | 2018-02-19 |
| 1780031724 | Wellness Source LLC | Clinic/Center | 6305 Ivy Ln Ste 101, Greenbelt, MD 20770-1465 | 2016-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805405 | Caring Hands Medical Clinic LLC | Nurse Practitioner | 7201 Handover Parkway, Suite B, Greenbelt, MD 20770 | 2020-09-10 |
| 1770107203 | Jeannette Nicole Welds | Social Worker | 7710-303 Hanover Parkway, Greenbelt, MD 20770 | 2020-06-01 |
| 1063032597 | Victory Clinical Research | Specialist | 7212 Hanover Parkway, Suite A, Greenbelt, MD 20770 | 2020-04-24 |
| 1336793884 | Yan Chen | Physician Assistant | 7300 Hanover Drive, Suite 104, Greenbelt, MD 20770 | 2019-08-01 |
| 1245884519 | Antonio Moody | Counselor | 7474 Greenbelt Center Drive, Greenbelt, MD 20770 | 2019-07-25 |
| 1881166494 | Jeniece Edwina Weddington | Speech-Language Pathologist | Eleanor Roosevelt High School- Pgcps, 7601 Hanover Parkway, Greenbelt, MD 20770 | 2018-12-20 |
| 1043797996 | Thomas Mesumbe | Home Health Aide | 6204 Sringhill Drive, Apartment 201, Greenbelt, MD 20770 | 2018-07-24 |
| 1063914554 | Zainab Anita Foday | Home Health Aide | 5923 Cherrywood Terrace Apt 101, Greenbelt, MD 20770 | 2018-03-01 |
| 1619479193 | Nancy Benga | Home Health Aide | 5821 Cherrywood Ln Apt 104 5821 Cherry Wood Ln Apt 104, Greenbelt, MD 20770 | 2018-03-01 |
| 1912407891 | Adoni Healthcare Services, LLC | Clinic/Center | 7525 Greenway Center Dr Ste 316, Greenbelt, MD 20770 | 2018-02-16 |
| Find all providers in zip 20770 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205445939 | New Millennial Counseling & Consulting, LLC | Clinic/Center | 7225 Hanover Pkwy Ste C, Greenbelt, MD 20770-2024 | 2020-07-29 |
| 1205257524 | Choice Clinical Services, LLC | Clinic/Center | 111 Centerway, Suite 202, Greenbelt, MD 20770-1808 | 2014-01-06 |
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| 1144837980 | King Health Systems, Inc. | Clinic/Center | 14201 Laurel Park Dr Ste 206, Laurel, MD 20707-5203 | 2020-09-25 |
| 1871109181 | Journey Health Center | Clinic/Center | 1808 Woodlawn Dr Ste O, Gwynn Oak, MD 21207-4023 | 2020-09-22 |
| 1801402656 | Desicare LLC | Clinic/Center | 7712 West Shore Road, Pasadena, MD 21122-1519 | 2020-09-17 |
| 1508472226 | Resilient Psychiatry, LLC | Clinic/Center | 744 Dulaney Valley Rd Ste 7, Towson, MD 21204-5132 | 2020-09-17 |
| 1356955298 | Peace In Perspective | Clinic/Center | 11 Far Corners Loop, Sparks, MD 21152-9256 | 2020-09-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.