Organization
RADICAL RESTORATIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATANYA NICOLE TOWNSEND PH.D, LCSW-C (CEO)
(410) 622-4818
Entity
Organization
Contact information
Practice address
1055 TAYLOR AVE STE 302, TOWSON, MD 21286-8334
(410) 622-4818
Mailing address
1055 TAYLOR AVE STE 302, TOWSON, MD 21286-8334
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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