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Organization

GAME TO GLORY RESTORE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEVIN WILLIAMS LCPC (CEO)
(240) 338-2534
Entity
Organization

Contact information

Practice address
2014 DUPONT AVE, SUITLAND, MD 20746-1030
(240) 338-2534
Mailing address
4405 LARGO RD, UPPER MARLBORO, MD 20772-7837
(240) 338-2534

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
11/15/2023
Last updated
11/15/2023
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