Healthcare Provider Details

I. General information

NPI: 1194620435
Provider Name (Legal Business Name): RESTORATION RECOVERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6771 LEANING OAK RD
OXFORD NC
27565
US

IV. Provider business mailing address

100 S GARNETT ST STE 175
HENDERSON NC
27536-4642
US

V. Phone/Fax

Practice location:
  • Phone: 919-339-9808
  • Fax:
Mailing address:
  • Phone: 919-339-9808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. THEARTIS DOREISE HOLMES
Title or Position: OWNER/CLINICIAN
Credential: LCAS
Phone: 919-482-6382