Organization
CHOICE RECOVERY HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRISTAN J SHOCKLEY MD (CEO/OWNER)
(202) 489-1125
Entity
Organization
Contact information
Practice address
100 BIDDLE AVE STE 101, NEWARK, DE 19702-3982
(410) 505-8605
(240) 770-0436
Mailing address
9123 OLD ANNAPOLIS RD STE 203&204, COLUMBIA, MD 21045-1953
(410) 505-8605
(240) 770-0436
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
05/26/2023
Last updated
07/03/2023
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