| 4 2 Restore Llc | |
|
3527 N Rolling Rd Ste 4 Windsor Mill MD 21244-2256 | |
| (410) 701-9190 | |
| (410) 701-7483 |
| Full Name | 4 2 Restore Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 3527 N Rolling Rd Ste 4, Windsor Mill, Maryland |
| Authorized Official Name and Position | Deadra Monique Martin (CEO) |
| Authorized Official Contact | 4107019190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4 2 Restore Llc 3527 N Rolling Rd Ste 4 Windsor Mill MD 21244-2256 Ph: (410) 701-9190 | 4 2 Restore Llc 3527 N Rolling Rd Ste 4 Windsor Mill MD 21244-2256 Ph: (410) 701-9190 |
| NPI Number | 1649882085 |
|---|---|
| Provider Enumeration Date | 08/18/2020 |
| Last Update Date | 10/13/2020 |
| Certification Date | 10/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649882085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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