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General NPI Number Information
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NPI Number | 1114676475
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Entity Type | Organization
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Legal Business Name | A RESTORED HOPE LLC
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 874 ARCHER RD
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City | BEDFORD
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State | OH
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Zip | 44146-2978
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Country | US
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Telephone | 216-423-6200
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Fax | 216-423-6230
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Provider Business Mailing Address
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Address Line | 874 ARCHER RD
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City | BEDFORD
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State | OH
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Zip | 44146-2978
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Country | US
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Telephone | 216-423-6200
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Fax | 216-423-6230
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MALADEAN HUDSON
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Credential | LPC
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Telephone | 216-426-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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