Healthcare Provider Details

I. General information

NPI: 1205325131
Provider Name (Legal Business Name): RESTORATION OF HOPE PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 E BENNETT ST STE H
SPRINGFIELD MO
65804-1425
US

IV. Provider business mailing address

644 S SCENIC AVE
SPRINGFIELD MO
65802-5072
US

V. Phone/Fax

Practice location:
  • Phone: 417-942-0005
  • Fax: 417-942-5772
Mailing address:
  • Phone: 417-942-0005
  • Fax: 417-942-5772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DEAN MILLER
Title or Position: EXECUTIVE DIRECTOR
Credential: LMSW, MSCJ
Phone: 417-942-0005