Provider Demographics
NPI:1184443095
Name:REACH REDEEM RESTORE WELLNESS LLC
Entity type:Organization
Organization Name:REACH REDEEM RESTORE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:INYANG
Authorized Official - Middle Name:AMINA
Authorized Official - Last Name:EDOHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-920-9103
Mailing Address - Street 1:708 PULASKI HWY STE B-1
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3926
Mailing Address - Country:US
Mailing Address - Phone:443-402-5052
Mailing Address - Fax:
Practice Address - Street 1:708 PULASKI HWY STE B-1
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3926
Practice Address - Country:US
Practice Address - Phone:443-402-5052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility