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General NPI Number Information
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NPI Number | 1295514834
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Entity Type | Organization
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Legal Business Name | EPOCH SOBER LIVING
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 2814 EMMORTON RD
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City | ABINGDON
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State | MD
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Zip | 21009-1625
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Country | US
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Telephone | 443-221-3025
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Fax |
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Provider Business Mailing Address
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Address Line | 330 CIGAR LOOP
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City | HAVRE DE GRACE
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State | MD
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Zip | 21078-2348
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Country | US
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Telephone | 443-221-3025
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | ROSALIE LORETTA BURNITE
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Credential |
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Telephone | 443-221-3025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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