Revitalized Family Ministries

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REVITALIZED FAMILY MINISTRIES

Practice address

310 Dockside CT
Brooklyn, MD 21225-2935

Phone

(410) 812-2521

NPI assigned

Jul 26, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Rae Gordon, LCSW-C

Title

Owner

Phone

(410) 812-2521

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1174801070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19797",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212250597",
            "telephone_number": "410-812-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 DOCKSIDE CT",
            "city": "BROOKLYN",
            "state": "MD",
            "postal_code": "212252935",
            "telephone_number": "410-812-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZED FAMILY MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-812-2521",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Paudel, PMHNP
• Peaceful Minds Residential Services
• Peoples Services Inc
• Ngoc T Pham
• Quality Life Residence Inc.
• Rode Health Services
• Shavene Ryals
• Patricia Santosham, M.D.
• Seuncares Therapy Center
• Kristen Sofley, LMT

• Community/Behavioral Health Agency in Brooklyn, MD
• Providers in Brooklyn, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.