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Organization
RESTORED LIVING LLC
Active
Organization
RESTORED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OKPENZE FELICIA BALLARD PMHNP (CEO)
(917) 378-2269
Entity
Organization
Contact information
Practice address
2484 OLD HARFORD RD, 2484 OLD HARFORD RD, PARKVILLE, MD 21234
(410) 882-1715
Mailing address
3044 CALIFORNIA AVE, PARKVILLE, MD 21234-4141
(917) 378-2269
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
363L00000X
Nurse Practitioner
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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