4 2 Restore Drug & Alcohol Recovery Center

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

4 2 RESTORE DRUG & ALCOHOL RECOVERY CENTER

Practice address

302 Park Ave
Baltimore, MD 21201-3618

Phone

(443) 500-4887

NPI assigned

Feb 6, 2019

Last updated

Feb 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deadra Monique Martin, PHDNPI 1174027361

Title

Ceo

Phone

(443) 500-4887

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deadra Monique Martin, PHD

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
  • NPI 1174027361
  Authorized official Same address or phone

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1750846465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013618",
            "telephone_number": "443-500-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013618",
            "telephone_number": "443-500-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4 2 RESTORE DRUG & ALCOHOL RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DEADRA",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-500-4887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 3330 Wilkens Avenue Operations LLC
• 33Rd Street Surgery Center LLC
• 360 Durable Medical Equipment and Supplies LLC
• 360 Rehabilitation & Chiropractic LLC
• 360 Therapy Group LLC
• 4 2 Restore LLC
• 4 Evergreen Recovery Homes and Services
• 4 Walls Health Services Inc.
• 444 Logistics LLC
• 6000 Bellona Avenue Operations LLC (Homewood Center)

• Substance Use Disorder Rehabilitation Clinic/Center in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.