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General NPI Number Information
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NPI Number | 1194514778
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Entity Type | Organization
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Legal Business Name | RESTORING HOPE MINISTRIES INC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 710 DESPLAINE RD
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City | DE PERE
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State | WI
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Zip | 54115-3718
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Country | US
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Telephone | 920-246-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 1132 REED ST
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City | GREEN BAY
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State | WI
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Zip | 54303-3023
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Country | US
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Telephone | 715-972-6182
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Fax | 715-972-6182
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Authorized Official
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Title or Position | LEAD COUNSELING PASTOR
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Name | DR. JEFFREY WILLIAM GROSS
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Credential | PHD, THD, MS, SAC-IT
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Telephone | 920-246-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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