Healthcare Provider Details

I. General information

NPI: 1144134073
Provider Name (Legal Business Name): RESTORATION HOPE HOUSE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 MAIN ST
INDIANOLA MS
38751-2935
US

IV. Provider business mailing address

1104 MAIN ST
INDIANOLA MS
38751-2935
US

V. Phone/Fax

Practice location:
  • Phone: 662-303-1800
  • Fax: 662-399-5042
Mailing address:
  • Phone: 662-303-1800
  • Fax: 662-399-5042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAKENDRA A LANGSTON
Title or Position: CEO
Credential:
Phone: 662-884-6624