Healthcare Provider Details

I. General information

NPI: 1396921201
Provider Name (Legal Business Name): RESTORATION FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 WILKINS ST
SMITHFIELD NC
27577
US

IV. Provider business mailing address

714 WILKINS ST
SMITHFIELD NC
27577-4648
US

V. Phone/Fax

Practice location:
  • Phone: 919-938-9502
  • Fax: 919-938-9702
Mailing address:
  • Phone: 919-938-9502
  • Fax: 919-938-9702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNC

VIII. Authorized Official

Name: MRS. RENEE HOLLOWAY JONES
Title or Position: PRESIDENT/CEO
Credential: LPC, LCASA
Phone: 919-938-9502