Gordon, Alexandra Marie

Gordon, Alexandra Marie is an sole proprietor health care provider with primary practice located at 10 Meadowbrook Rd , Brockton MA 02301-7122. She recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as her primary health care specialty. Gordon, Alexandra Marie can be contacted via phone (774) 330-8944.

Contact Information

Primary practice address
10 Meadowbrook Rd Brockton MA 02301-7122
Phone: (774) 330-8944
Fax: (508) 408-6192
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X Massachusetts

Profile Details

NPI number 1063930337
LBN Legal business name Gordon, Alexandra Marie
Credentials ON CALL RECOVERY COA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 6th, 2017
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063930337 NPPES
Massachusetts MEDICAID 1518996354

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