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General NPI Number Information
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NPI Number | 1861913543
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Entity Type | Organization
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Legal Business Name | RESTORATION COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 8331 OFFICE PARK DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30134
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Country | US
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Telephone | 770-880-6498
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Fax |
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Provider Business Mailing Address
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Address Line | 8331 OFFICE PARK DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-6937
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Country | US
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Telephone | 770-880-8437
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. KIMBERLY DAWN ARNOLD
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Credential | M.A., LAPC, NCC
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Telephone | 770-880-8437
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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 | APC005853
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License Number State | GA
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