Healthcare Provider Details

I. General information

NPI: 1679209563
Provider Name (Legal Business Name): RESTORE AT A RAY OF HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 N MARKET ST
BATAVIA OH
45103-2906
US

IV. Provider business mailing address

33 N MARKET ST
BATAVIA OH
45103-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-409-3635
  • Fax: 513-402-0408
Mailing address:
  • Phone: 513-409-3635
  • Fax: 513-402-0408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: YVONNE FERNANDEZ
Title or Position: DIRECTOR
Credential:
Phone: 513-409-3635