Kellys Support Services of Maryland

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

KELLYS SUPPORT SERVICES OF MARYLAND

Practice address

3920 Rock Spring Dr
Upper Marlboro, MD 20772-3993

Phone

(919) 444-1550

NPI assigned

Sep 12, 2022

Organization subpart

No

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

Authorized official

Name

Kelly Anye MiyangNPI 1104185149

Title

Executive Durector

Phone

(919) 444-1550

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kelly Anye Miyang

  • Registered Nurse
  • Washington, DC
  • NPI 1104185149
  NPD Authorized official

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1871214510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 ROCK SPRING DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723993",
            "telephone_number": "919-444-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 ROCK SPRING DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723993",
            "telephone_number": "919-444-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLYS SUPPORT SERVICES OF MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "MIYANG",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANYE",
        "authorized_official_title_or_position": "EXECUTIVE DURECTOR",
        "authorized_official_telephone_number": "919-444-1550"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Karugia
• Tinita O Kearney, PH.D., CCC-SLP/L
• Adeolu Tolulope Kehinde, PT
• Natasha Kehla
• Keliz Inc
• Alex B Kengne Tatsinkam
• Kennedy Family Medicine
• Nathan Kennedy, DC
• Laponda Kersey
• Aysha Khan, M.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.