Healthcare Provider Details

I. General information

NPI: 1972895738
Provider Name (Legal Business Name): RESTORATION COUNSELING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 FAIRGROUND RD
CELINA OH
45822-9775
US

IV. Provider business mailing address

5100 FAIRGROUND RD
CELINA OH
45822-9775
US

V. Phone/Fax

Practice location:
  • Phone: 419-586-9700
  • Fax: 419-586-1414
Mailing address:
  • Phone: 419-586-9700
  • Fax: 419-586-1414

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 Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: BOBBI LYNN STONER
Title or Position: DIRECTOR
Credential: LSW LICDC
Phone: 419-586-9700