Provider Demographics
NPI:1790282119
Name:FIRST STOP RECOVERY RESOURCE AND WELLNESS CENTER
Entity Type:Organization
Organization Name:FIRST STOP RECOVERY RESOURCE AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:LENORA
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-640-3903
Mailing Address - Street 1:4805 1ST ST SW UNIT A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2729
Mailing Address - Country:US
Mailing Address - Phone:240-640-3903
Mailing Address - Fax:
Practice Address - Street 1:4805 1ST ST SW UNIT A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2729
Practice Address - Country:US
Practice Address - Phone:240-640-3903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome HealthGroup - Multi-Specialty