4 2 RESTORE LLC - NPI 1649882085 - Clinic/Center in Windsor Mill, MD

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QM0855X and a focus in Adolescent and Children Mental Health.

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About 4 2 Restore Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

4 2 RESTORE LLC (NPI 1649882085) is a healthcare organization registered as an adolescent and children mental health in Windsor Mill, Maryland and active in the NPI registry since August 2020. The organization lists Deadra Monique Martin, Ceo, as its authorized official.

NPPES Registry Identity

NPI1649882085

Entity TypeOrganization

Primary Taxonomy261QM0855X

Legal Business Name4 2 RESTORE LLC

Location Address3527 N ROLLING RD STE 4Windsor Mill, MD 21244-2256

Mailing Address3527 N Rolling Rd Ste 4Windsor Mill, MD 21244-2256 · (410) 701-9190 · Fax (410) 701-7483

Phone(410) 701-9190

Fax(410) 701-7483

Organization SubpartNo

Authorized OfficialDeadra Monique MartinCeo · (410) 701-9190

Enumeration DateAugust 18, 2020

Last NPPES UpdateOctober 13, 20203 updates tracked since enumeration

NPPES CertifiedOctober 13, 2020

✔ NPI 1649882085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0855X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

3527 N ROLLING RD STE 4, Windsor Mill, MD 21244

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