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General NPI Number Information
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NPI Number | 1811031107
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Entity Type | Organization
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Legal Business Name | RESTORATION CONCEPTS, INC.
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 809 N LAFAYETTE ST SUITE A
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City | SHELBY
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State | NC
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Zip | 28150-3978
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Country | US
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Telephone | 704-481-8379
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Fax | 704-481-8571
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Provider Business Mailing Address
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Address Line | 809 N LAFAYETTE ST SUITE A
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City | SHELBY
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State | NC
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Zip | 28150-3978
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Country | US
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Telephone | 704-481-8379
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Fax | 704-481-8571
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PHILIP J GOLDBERG
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Credential |
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Telephone | 704-481-8379
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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 |
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License Number State | NC
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