Provider Demographics
NPI:1649900036
Name:RESTORATION WELLNESS CENTER INC
Entity type:Organization
Organization Name:RESTORATION WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLAYEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAJUYIGBE
Authorized Official - Suffix:
Authorized Official - Credentials:PMNHP
Authorized Official - Phone:443-538-6352
Mailing Address - Street 1:2 W ROLLING XRDS STE 207
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6211
Mailing Address - Country:US
Mailing Address - Phone:443-538-6352
Mailing Address - Fax:
Practice Address - Street 1:2 W ROLLING XRDS STE 207
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6211
Practice Address - Country:US
Practice Address - Phone:443-538-6352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health