Organization · Type 2 NPI
Restore 360 LLC
Psychiatric/Mental Health Nurse Practitioner · Philadelphia, PA
NPI number
1790350015
Active
Practice location
7516 City Ave Ste 7&8
Philadelphia, PA 19151-2102
Fax (484) 373-2710
Mailing address
600 Stetson Rd
Elkins Park, PA 19027-2525
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1790350015
Restore 360 LLC's National Provider Identifier is 1790350015, issued on May 20, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Philadelphia, PA. The record was last updated on Jan 9, 2024.