NPI | 1104523968 |
---|---|
Doing Business As | RESTORE BEHAVIORAL SERVICES LLC. |
Entity Type | Organization |
Authorized Contact | DOMINIQUE WASHINGTON-SMITH CEO/Owner 757-509-4984 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2023-02-13 |
Last Update Date | 2023-09-19 |