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Organization

RESTORE 360 LLC

Active
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Organization

RESTORE 360 LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OLUWASEYI EFFRAIM (EXECUTIVE DIRECTOR)
(484) 373-2710
Entity
Organization

Contact information

Practice address
7516 CITY AVE STE 7&8, PHILADELPHIA, PA 19151-2102
(484) 373-2710
(484) 373-2710
Mailing address
600 STETSON RD, ELKINS PARK, PA 19027-2525
(510) 504-4138

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—

Other

Enumeration date
05/20/2021
Last updated
01/09/2024
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