| Graceful Dove Recovery, Llc | |
|
214 E Randall St Baltimore MD 21230-4652 | |
| (240) 712-1851 | |
| Not Available |
| Full Name | Graceful Dove Recovery, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 214 E Randall St, Baltimore, Maryland |
| Authorized Official Name and Position | Melissa Christine Lee Furmage (OWNER) |
| Authorized Official Contact | 2407121851 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Graceful Dove Recovery, Llc 214 E Randall St Baltimore MD 21230-4652 Ph: (240) 712-1851 | Graceful Dove Recovery, Llc 214 E Randall St Baltimore MD 21230-4652 Ph: (240) 712-1851 |
| NPI Number | 1609596105 |
|---|---|
| Provider Enumeration Date | 09/02/2022 |
| Last Update Date | 09/02/2022 |
| Certification Date | 08/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609596105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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