| Restore Behavioral Health | |
|
3131 Taylor Ave Elmwood Park WI 53405-4524 | |
| (773) 910-6003 | |
| Not Available |
| Full Name | Restore Behavioral Health |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3131 Taylor Ave, Elmwood Park, Wisconsin |
| Authorized Official Name and Position | Brian M Larsen (CEO) |
| Authorized Official Contact | 7739106003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Behavioral Health 4123 Meachem Rd Mount Pleasant WI 53403-3912 Ph: (773) 910-6003 | Restore Behavioral Health 3131 Taylor Ave Elmwood Park WI 53405-4524 Ph: (773) 910-6003 |
| NPI Number | 1487288452 |
|---|---|
| Provider Enumeration Date | 02/27/2020 |
| Last Update Date | 02/27/2020 |
| Certification Date | 02/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487288452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Stephanie Mazzanti Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3131 Taylor Ave, Elmwood Park, WI 53405 Phone: 312-608-0097 |