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General NPI Number Information
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NPI Number | 1669027801
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Entity Type | Organization
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Legal Business Name | STORMY WEATHER RECOVERY, LLC
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 4712 DUNKIRK AVE
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City | BALTIMORE
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State | MD
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Zip | 21229-3318
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Country | US
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Telephone | 800-484-8007
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2703
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City | BROOKLYN
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State | MD
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Zip | 21225-0703
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Country | US
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Telephone | 800-484-8007
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. CARISMA GOVAN-FACEY
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Credential |
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Telephone | 800-484-8007
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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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Taxonomy #2
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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