Provider Demographics
NPI:1699488023
Name:RESTORATIVE BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:RESTORATIVE BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLEEN
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:GONDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-418-3234
Mailing Address - Street 1:8500 COASTAL HWY UNIT 906
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-7744
Mailing Address - Country:US
Mailing Address - Phone:908-418-3234
Mailing Address - Fax:
Practice Address - Street 1:9956 N MAIN ST UNIT 4
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1077
Practice Address - Country:US
Practice Address - Phone:908-418-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)