Organization
GAME TO GLORY RESTORE LLC
Active
Other names
Game To Glory Restore
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WILLIAMS LCPC (DIRECTOR)
(240) 338-2534
Entity
Organization
Contact information
Practice address
413 MAIN ST STE 1, LAUREL, MD 20707-7101
(240) 338-2534
Mailing address
4405 LARGO RD, UPPER MARLBORO, MD 20772-7837
(240) 338-2534
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/27/2023
Last updated
04/22/2025
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