# SELF RESTORATIVE SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912793043
- **Authorized official:** SYDNEY-SHIANN JONES (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (240) 968-2809

## Contact information

- **Practice address:** 218 COLLINS AVE, BALTIMORE, MD 21229-3611
- **Practice address phone:** (240) 968-2809
- **Mailing address:** 218 COLLINS AVE, BALTIMORE, MD 21229-3611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/16/2025
- **Last updated:** 04/16/2025