Organization
SELF RESTORATIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYDNEY-SHIANN JONES (CHIEF EXECUTIVE OFFICER)
(240) 968-2809
Entity
Organization
Contact information
Practice address
218 COLLINS AVE, BALTIMORE, MD 21229-3611
(240) 968-2809
Mailing address
218 COLLINS AVE, BALTIMORE, MD 21229-3611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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