Licurgo, Jordan
Licurgo, Jordan is an individual health care provider with primary practice located at 30007 Business Center Dr , Charlotte Hall MD 20622-3101. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Licurgo, Jordan can be contacted via phone (301) 997-1300.Contact Information
Primary practice address
30007 Business Center Dr
Charlotte Hall MD 20622-3101
Phone: (301) 997-1300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1487243275 |
|---|---|
| LBN Legal business name | Licurgo, Jordan |
| Credentials | ADT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2021 |
| Last updated | Jan 15th, 2021 - 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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