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General NPI Number Information
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NPI Number | 1235218884
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Entity Type | Organization
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Legal Business Name | RESTORATION MINISTRIES INC.
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2113 LITTLE FLOCK DR
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City | ROGERS
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State | AR
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Zip | 72756-7042
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Country | US
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Telephone | 479-621-0385
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Fax |
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Provider Business Mailing Address
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Address Line | 2113 LITTLE FLOCK DR
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City | ROGERS
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State | AR
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Zip | 72756-7042
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Country | US
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Telephone | 479-621-0385
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DAVID ENGLE
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Credential |
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Telephone | 479-631-7345
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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 | A0306058
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License Number State | AR
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