Organization
REVITALIZED FAMILY MINISTRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA RAE GORDON LCSW-C (OWNER)
(410) 812-2521
Entity
Organization
Contact information
Practice address
310 DOCKSIDE CT, BROOKLYN, MD 21225-2935
(410) 812-2521
Mailing address
PO BOX 19797, BALTIMORE, MD 21225-0597
(410) 812-2521
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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