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Organization
FAMILY RECOVERY PROGRAM
Active
Organization
FAMILY RECOVERY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOCELYN GAINERS (CEO/DIRECTOR)
(410) 605-0492
Entity
Organization
Contact information
Practice address
239 N GAY ST, BALTIMORE, MD 21202-4822
(410) 605-0492
Mailing address
239 N GAY ST, BALTIMORE, MD 21202-4822
(410) 605-0492
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
NULL
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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