Healthcare Provider Details
I. General information
NPI: 1669132411
Provider Name (Legal Business Name): RESTORATION COUNSELING AND CONSULTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/21/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6100 SEAGULL ST NE STE B-205
ALBUQUERQUE NM
87109-2500
US
IV. Provider business mailing address
PO BOX 93754
ALBUQUERQUE NM
87199-3754
US
V. Phone/Fax
- Phone: 254-681-8015
- Fax:
- Phone: 505-309-4132
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
J.
BLOUNT
Title or Position: OWNER
Credential: LPCC
Phone: 505-309-4132