| NPI | 1134980618 |
|---|---|
| Doing Business As | LIFE RESTORATION RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | MONICA LAWRENCE Credentialing Specialist 502-656-2429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |