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General NPI Number Information
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NPI Number | 1285888313
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Entity Type | Organization
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Legal Business Name | RESTORATIVE MANAGEMENT CORP
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 15 KING STREET
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City | MIDDLETOWN
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State | NY
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Zip | 10940
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Country | US
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Telephone | 845-342-5941
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Fax |
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Provider Business Mailing Address
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Address Line | 135 OCEAN PKWY APT 1N
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City | BROOKLYN
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State | NY
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Zip | 11218-2579
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Country | US
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Telephone | 718-436-5151
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | MS. LEAH BOROHOV
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Credential |
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Telephone | 718-426-5151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 061110960
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License Number State | NY
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