Provider Demographics
NPI:1851128599
Name:RECLAIM AND RESTORE HEALING COMPANY
Entity type:Organization
Organization Name:RECLAIM AND RESTORE HEALING COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:LGPC, CAC-AD
Authorized Official - Phone:410-823-5357
Mailing Address - Street 1:2120 EMMORTON PARK RD STE E
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1066
Mailing Address - Country:US
Mailing Address - Phone:410-823-5357
Mailing Address - Fax:213-289-8532
Practice Address - Street 1:2120 EMMORTON PARK RD STE E
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1066
Practice Address - Country:US
Practice Address - Phone:410-823-5357
Practice Address - Fax:213-289-8532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty