4 2 Restore LLC
Psychiatric Hospital in Windsor Mill, MD. Organization (NPI-2).
NPI number1982216412
StatusActive
Last updated in NPPESOct 13, 2020
Details
- NPI
- 1982216412
- Entity type
- Organization (NPI-2)
- Legal business name
- 4 2 Restore LLC
- Organization subpart
- No
- Enumeration date
- Aug 17, 2020
- Certification date
- Oct 13, 2020
- Last updated
- Oct 13, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 283Q00000X | Psychiatric Hospital | – | – | Yes |
Practice location
3527 N Rolling Rd Ste 4Windsor Mill, MD 21244-2256
Phone 410-701-9190 · Fax 410-701-7483
Mailing address
3527 N Rolling Rd Ste 4Windsor Mill, MD 21244-2256
Phone 410-701-9190 · Fax 410-701-7483
Authorized official
Deadra Monique Martin
Ceo
4107019190
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