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General NPI Number Information
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NPI Number | 1699488023
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Entity Type | Organization
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Legal Business Name | RESTORATIVE BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 12/30/2022
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 9956 N MAIN ST UNIT 4
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City | BERLIN
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State | MD
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Zip | 21811-1077
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Country | US
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Telephone | 908-418-3234
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Fax |
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Provider Business Mailing Address
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Address Line | 8500 COASTAL HWY UNIT 906
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City | OCEAN CITY
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State | MD
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Zip | 21842-7744
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Country | US
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Telephone | 908-418-3234
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHARLEEN LAUREN GONDEN
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Credential |
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Telephone | 908-418-3234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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