# FAMILY RECOVERY PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063067049
- **Authorized official:** DR. JOCELYN GAINERS (CEO/DIRECTOR)
- **Authorized official phone:** (410) 605-0492

## Contact information

- **Practice address:** 239 N GAY ST, BALTIMORE, MD 21202-4822
- **Practice address phone:** (410) 605-0492
- **Mailing address:** 239 N GAY ST, BALTIMORE, MD 21202-4822
- **Mailing address phone:** (410) 605-0492

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | — | — | — |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/06/2019
- **Last updated:** 08/06/2019