Healthcare Provider Details

I. General information

NPI: 1336061720
Provider Name (Legal Business Name): RESTORATION RECOVERY MINISTRIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5192 264 ALT
BAILEY NC
27807
US

IV. Provider business mailing address

5192 264 ALT
BAILEY NC
27807
US

V. Phone/Fax

Practice location:
  • Phone: 252-373-7091
  • Fax:
Mailing address:
  • Phone: 252-373-7091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK ANTHONY WINSTEAD JR.
Title or Position: OWNER
Credential: CPSS
Phone: 252-373-7091