| Refocus Renew Restore Llc | |
|
201 Prospect Ave Ste 316 Hagerstown MD 21742-3204 | |
| (240) 614-6170 | |
| (240) 252-7518 |
| Full Name | Refocus Renew Restore Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 Prospect Ave Ste 316, Hagerstown, Maryland |
| Authorized Official Name and Position | Toni Maxwell (OWNER) |
| Authorized Official Contact | 2406146170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Refocus Renew Restore Llc 201 Prospect Ave Ste 316 Hagerstown MD 21742-3204 Ph: (240) 614-6170 | Refocus Renew Restore Llc 201 Prospect Ave Ste 316 Hagerstown MD 21742-3204 Ph: (240) 614-6170 |
| NPI Number | 1710649900 |
|---|---|
| Provider Enumeration Date | 10/06/2021 |
| Last Update Date | 02/26/2025 |
| Certification Date | 02/26/2025 |
| Medicare PECOS PAC ID | 2466977202 |
|---|---|
| Medicare Enrollment ID | O20250415001129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710649900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Toni Maxwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699226258 PECOS PAC ID: 0749705580 Enrollment ID: I20250415001100 |
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