Healthcare Provider Details
I. General information
NPI: 1770434912
Provider Name (Legal Business Name): RESTORATION OF FAITH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1348 E VERNON AVE
LOS ANGELES CA
90011-3723
US
IV. Provider business mailing address
1348 E VERNON AVE
LOS ANGELES CA
90011-3723
US
V. Phone/Fax
- Phone: 213-330-9680
- Fax:
- Phone: 213-330-9680
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERANISHA
TESHEA
BESS
Title or Position: CEO
Credential:
Phone: 213-330-9680