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General NPI Number Information
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NPI Number | 1235130881
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Entity Type | Organization
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Legal Business Name | RESTORATION MINISTRIES, INTERNATIONAL
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 2755 S LOCUST ST SUITE 209
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City | DENVER
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State | CO
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Zip | 80222-7126
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Country | US
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Telephone | 303-753-6677
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Fax | 303-753-6868
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Provider Business Mailing Address
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Address Line | 2755 S LOCUST ST SUITE 209
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City | DENVER
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State | CO
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Zip | 80222-7126
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Country | US
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Telephone | 303-753-6677
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Fax | 303-753-6868
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR/COUNSELOR/TEACHE
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Name | MS. MARY JEAN ORR
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Credential | MSW, LCSW
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Telephone | 303-753-6677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 876226
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License Number State | CO
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