Provider Demographics
NPI:1710037759
Name:FIRST STEP RECOVERY CENTER, INC.
Entity Type:Organization
Organization Name:FIRST STEP RECOVERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:410-280-2333
Mailing Address - Street 1:1419 FOREST DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-1482
Mailing Address - Country:US
Mailing Address - Phone:410-280-2333
Mailing Address - Fax:410-280-9866
Practice Address - Street 1:1419 FOREST DR
Practice Address - Street 2:SUITE 104
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-1482
Practice Address - Country:US
Practice Address - Phone:410-280-2333
Practice Address - Fax:410-280-9866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA026251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health