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4 2 Restore, LLC

Organization Active NPI Adult Mental Health Clinic/Center · Windsor Mill, MD

NPI 1912401183 · NPPES record last updated Jun 10, 2020

Key facts

NPI
1912401183
Entity type
Organization (NPI type 2)
Primary specialty
Adult Mental Health Clinic/Center 261QM0850X
Legal business name
4 2 RESTORE, LLC
Practice address
8310 Liberty Rd Ste 2C
Windsor Mill, MD 21244-3124
Phone
(443) 500-4887
NPI assigned
Mar 21, 2018
Organization subpart
No

Authorized official

Name
Dr. Deadra M Martin, PHD
Title
Owner/Program Coordinator
Phone
(443) 500-4887

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
4 2 Restore LLC (8 organizations share this tax ID)

Locations

8310 Liberty Rd
Ste 2C
Windsor Mill, MD 21244
Phone (443) 500-4887

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Yes
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

8310 Liberty Rd Ste 2C
Windsor Mill, MD 21244-3124

Mailing address

3527 N Rolling Rd Ste 4
Windsor Mill, MD 21244-2256
Phone (443) 500-4887

Other practice location 1

8310 Liberty Rd
Baltimore, MD 21244-3124
Phone (443) 500-4887

Other providers in Windsor Mill, MD

All providers in Windsor Mill, MD · Adult Mental Health Clinic/Center in Maryland

Sources for this page

Verify at the official NPI Registry.