Provider Demographics
NPI:1194873588
Name:GALE RECOVERY, INC.
Entity type:Organization
Organization Name:GALE RECOVERY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BIRNBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-662-2303
Mailing Address - Street 1:608 E PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5732
Mailing Address - Country:US
Mailing Address - Phone:301-662-2303
Mailing Address - Fax:301-694-8527
Practice Address - Street 1:336 N MARKET ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5337
Practice Address - Country:US
Practice Address - Phone:301-662-2303
Practice Address - Fax:301-694-8527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD102337324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52200401Medicare ID - Type UnspecifiedMD MEDICAL CARE PROGRAMS