# RESTORED LIVING LLC

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

## Provider details

- **NPI number:** 1992525679
- **Authorized official:** OKPENZE FELICIA BALLARD PMHNP (CEO)
- **Authorized official phone:** (917) 378-2269

## Contact information

- **Practice address:** 2484 OLD HARFORD RD, 2484 OLD HARFORD RD, PARKVILLE, MD 21234
- **Practice address phone:** (410) 882-1715
- **Mailing address:** 3044 CALIFORNIA AVE, PARKVILLE, MD 21234-4141
- **Mailing address phone:** (917) 378-2269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251J00000X | Nursing Care Agency | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | — | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 385H00000X | Respite Care | — | — | — |

## Other

- **Enumeration date:** 10/16/2024
- **Last updated:** 10/16/2024