Healthcare Provider Details

I. General information

NPI: 1962950352
Provider Name (Legal Business Name): RESTORATION MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 N 7TH ST
FORT PIERCE FL
34950-3109
US

IV. Provider business mailing address

PO BOX 2375
FORT PIERCE FL
34954-2375
US

V. Phone/Fax

Practice location:
  • Phone: 954-746-8232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRANCES WATSON
Title or Position: OWNER
Credential:
Phone: 772-468-7900