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General NPI Number Information
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NPI Number | 1114116324
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Entity Type | Organization
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Legal Business Name | RESTORATION SOCIETY, INC.
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 327 ELM ST
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City | BUFFALO
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State | NY
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Zip | 14203-1634
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Country | US
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Telephone | 716-884-5216
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Fax | 716-884-2847
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Provider Business Mailing Address
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Address Line | 66 ENGLEWOOD AVE
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City | BUFFALO
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State | NY
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Zip | 14214-1235
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Country | US
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Telephone | 716-832-2141
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Fax | 716-832-0021
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Authorized Official
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Title or Position | CEO/CFO
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Name | MR. JOHN R. GUASTAFERRO JR.
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Credential |
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Telephone | 716-832-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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