4 2 Restore LLC
Organization Active NPI Adult Mental Health Clinic/Center · Windsor Mill, MD
NPI 1790398154 · NPPES record last updated Oct 13, 2020
Key facts
- NPI
- 1790398154
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Mental Health Clinic/Center 261QM0850X
- Legal business name
- 4 2 RESTORE LLC
- Practice address
- 3527 N Rolling Rd Ste 4
Windsor Mill, MD 21244-2256 - Phone
- (410) 701-9190
- Fax
- (410) 701-7438
- NPI assigned
- Aug 26, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Deadra Monique Martin
- Title
- Ceo
- Phone
- (410) 701-9190
Corporate family (same tax ID) 7
National Provider Directory
- Tax ID family
- 4 2 Restore LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | Yes |
Addresses
Primary practice location
3527 N Rolling Rd Ste 4
Windsor Mill, MD 21244-2256
Mailing address
3527 N Rolling Rd Ste 4
Windsor Mill, MD 21244-2256
Phone (410) 701-9190
Other providers in Windsor Mill, MD
- 4 2 Restore LLC
- 4 2 Restore LLC
- 4 2 Restore LLC
- 4 2 Restore LLC
- 4 2 Restore LLC
- 4 2 Restore, LLC
- A Better Situation Youth Services, Inc
- A Bright First Inc
- A Bright First Inc
All providers in Windsor Mill, MD · Adult Mental Health Clinic/Center in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.