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General NPI Number Information
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NPI Number | 1699241380
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Entity Type | Organization
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Legal Business Name | REDEEMED AND RESTORED, INC.
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 2010 CADIZ RD
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-8582
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Country | US
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Telephone | 270-498-1426
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 486
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City | HOPKINSVILLE
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State | KY
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Zip | 42241-0486
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Country | US
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Telephone | 270-498-1426
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CANDICE GROVES
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Credential |
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Telephone | 270-498-1426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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