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Organization

RESTORE BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN M LARSEN LPC (CEO)
(773) 910-6003
Entity
Organization

Contact information

Practice address
3131 TAYLOR AVE, ELMWOOD PARK, WI 53405-4524
(773) 910-6003
Mailing address
4123 MEACHEM RD, MOUNT PLEASANT, WI 53403-3912
(773) 910-6003

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
02/27/2020
Last updated
02/27/2020
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