RESTORE 360 LLC
NPI 1790350015
Nurse Practitioner - Psychiatric/Mental Health in Philadelphia, PA

Q: What is Restore 360 LLC's NPI number?

The NPI number for Restore 360 LLC is 1790350015. It was assigned to this organization in the NPPES registry on May 20, 2021.

Q: What is Restore 360 LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Restore 360 LLC was last updated on January 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 20, 2021

7516 CITY AVE STE 7&8, PHILADELPHIA, PA 19151(484) 373-2710(484) 373-2710 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 11, 2023, May 20, 2021 (2 updates tracked since 2021).

On this page

About Restore 360 Llc NPPES

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

RESTORE 360 LLC (NPI 1790350015) is a healthcare organization registered as a psychiatric/mental health in Philadelphia, Pennsylvania and active in the NPI registry since May 2021. The organization lists Oluwaseyi Effraim, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1790350015

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameRESTORE 360 LLC

Location Address7516 CITY AVE STE 7&8Philadelphia, PA 19151-2102

Mailing Address600 Stetson RdElkins Park, PA 19027-2525 · (510) 504-4138

Phone(484) 373-2710

Fax(484) 373-2710

Organization SubpartNo

Authorized OfficialOluwaseyi EffraimExecutive Director · (484) 373-2710

Enumeration DateMay 20, 2021

Last NPPES UpdateJanuary 9, 20242 updates tracked since enumeration

NPPES CertifiedJanuary 9, 2024

✔ NPI 1790350015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

7516 CITY AVE STE 7&8, Philadelphia, PA 19151

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Restore 360 Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Restore 360 LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Oluwaseyi Effraim, MPH MSN CRNP PMHNP

Nurse Practitioner

NPI 1902586043

7516 CITY AVE STE 7&8
Philadelphia, PA 19151

(484) 383-2710

✔ PECOS✔ Accepts MedicareSame address

Maleakah Briggs, LPC

Mental Health Counselor

NPI 1912655341

6230 MAGNOLIA ST
Philadelphia, PA 19144

(610) 945-6441

✔ PECOS6.8 mi

Oluwadamilola Fowowe, CRNP

Nurse Practitioner

NPI 1760838783

680 BLAIR MILL RD
Horsham, PA 19044

(215) 902-9014

✔ PECOS✔ Accepts Medicare15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Restore 360 LLC's NPI number?

The NPI number for Restore 360 LLC is 1790350015. It was assigned to this organization in the NPPES registry on May 20, 2021.

Where is Restore 360 LLC located?

Restore 360 LLC is located at 7516 City Ave Ste 7&8, Philadelphia, PA 19151. The listed phone number is (484) 373-2710.

What is Restore 360 LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Restore 360 LLC enrolled in Medicare?

Yes. Restore 360 LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Restore 360 LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Restore 360 LLC, in Mental Health Counselor and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Restore 360 LLC was last updated on January 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.