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General NPI Number Information
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NPI Number | 1851128599
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Entity Type | Organization
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Legal Business Name | RECLAIM AND RESTORE HEALING COMPANY
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 2120 EMMORTON PARK RD STE E
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City | EDGEWOOD
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State | MD
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Zip | 21040-1066
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Country | US
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Telephone | 410-823-5357
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Fax | 213-289-8532
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Provider Business Mailing Address
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Address Line | 2120 EMMORTON PARK RD STE E
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City | EDGEWOOD
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State | MD
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Zip | 21040-1066
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Country | US
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Telephone | 410-823-5357
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Fax | 213-289-8532
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | ALANA MARIE O'NEILL
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Credential | LGPC, CAC-AD
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Telephone | 410-823-5357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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