Spectrum of Hope-Health Wellness and Community Services

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SPECTRUM OF HOPE-HEALTH WELLNESS AND COMMUNITY SERVICES

Practice address

5711 Sarvis Ave Ste 100
Riverdale, MD 20737-1363

Phone

(301) 850-8955

Fax

(301) 882-9732

NPI assigned

Dec 3, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Abila V Tazanu, MDNPI 1922043017

Title

Medical Director

Phone

(301) 850-8955

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Spectrum of Hope-Health Wellness and Community Services Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abila Violet Tazanu, MD

  • Pediatrics Physician
  • Lanham, MD
  • NPI 1922043017
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1023776374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 STARLING LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082835",
            "telephone_number": "301-957-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5711 SARVIS AVE STE 100",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371363",
            "telephone_number": "301-850-8955",
            "fax_number": "301-882-9732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12303 Starling Ln",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207082835",
            "country_code": "US",
            "telephone_number": "301-957-1382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECTRUM OF HOPE-HEALTH WELLNESS AND COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "TAZANU",
        "authorized_official_first_name": "ABILA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-850-8955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008686000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum of Hope-Health Wellness and Community Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Spectrum of Hope-Health Wellness and Community Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Latasha Monique Snell Gatling
• Augustine Osabii Sob, HHA
• Rosette Sontia
• Southern Maryland Medical Group LLC
• Toyosi Olabisi Sowemimo
• Katia R Stewart, M.D.
• Clayton W Straughn, M.D.
• Kimberly Street, P.T.
• Saritha Sudharsun
• Risikat Sulaimon

• Health Service Clinic/Center in Riverdale, MD
• Providers in Riverdale, MD by specialty
• Health Service Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.