| Organization Name: | TREBOR ALZHEIMER'S AND SENIOR SUPPORT CENTER, LLC |
| NPI Number: | 1306253034 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARGARETT BALTIMORE (RESIDENT AGENT) |
| Mailing Address: | 11512 Marjorie Drive Mitchellville |
| State: | MD US |
| Postal Code: | 20721 |
| Phone Number: | 3014122567 |
| Fax Number: | 3012184586 |
| NPI Enumeration Date: | 07/15/2014 |
| NPI Last Update Date: | 07/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |