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NPI Code Detail

MEDICARE: RESTORATIVE BEHAVIORAL HEALTH SERVICES LLC

MEDICARE: RESTORATIVE BEHAVIORAL HEALTH SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1699928762
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESTORATIVE BEHAVIORAL HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 225 WEATHERS CT
Second Line : STE 109 #25
City : YOUNGSVILLE
State : NC
Zip : 27596-7852
Country : US
Telephone Number : 919-283-5444
Fax Number : 866-583-9593
Provider Business Practice Location Address
First Line : 88 WHEATON DR
Second Line :
City : YOUNGSVILLE
State : NC
Zip : 27596-8691
Country : US
Telephone Number : 919-283-5444
Fax Number : 866-583-9593
Authorized Official
Title or Position : DIRECTOR
Name : MRS. CRYSTAL DENEE' BUSH
Credential : MSW, PLCSW
Telephone Number : 919-995-9284
Provider Enumeration Date : 11/03/2008
Last Update Date : 11/03/2008

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Directions to “RESTORATIVE BEHAVIORAL HEALTH SERVICES LLC ” Practice Location

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