4 2 RESTORE LLC – NPI #1336751866
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

4 2 RESTORE LLC is a substance abuse rehabilitation facility located in BALTIMORE, MD. NPPES has assigned the NPI number 1336751866 to 4 2 RESTORE LLC on August 17, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was previously updated about 5 years ago on Jun 11, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 4 2 RESTORE LLC below.

NPI Profile for
4 2 RESTORE LLC

NPI Number
1336751866
Enumeration Date

(about 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
4 2 RESTORE LLC
Primary location
2506 ROSLYN AVE
BALTIMORE, MD 21216-2214
Phone: (410) 701-9190 Fax: (410) 901-7483
Mailing address
3527 N ROLLING RD STE 4
WINDSOR MILL, MD 21244-2256
Phone: (410) 701-9190 Fax: (410) 901-7483
Organization Subpart
No
Authorized Official
DEADRA MARTIN
CEO
Phone: (410) 701-9190
Updated
Certification Date
Jun 11, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.