Healthcare Provider Details

I. General information

NPI: 1679425144
Provider Name (Legal Business Name): ASMARA RECOVERY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 3RD ST NE
WASHINGTON DC
20002-6274
US

IV. Provider business mailing address

1140 3RD ST NE
WASHINGTON DC
20002-6274
US

V. Phone/Fax

Practice location:
  • Phone: 240-701-2670
  • Fax:
Mailing address:
  • Phone: 240-701-2670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. KARIDJA STEPHANIE GOHOURE
Title or Position: OWNER
Credential:
Phone: 240-701-2670