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General NPI Number Information
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NPI Number | 1982119681
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Entity Type | Organization
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Legal Business Name | RESTORATION & NEW BEGINNINGS, LLC
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 111 PETROL PT STE G
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1573
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Country | US
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Telephone | 470-629-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 434 LAKE RIDGE LN
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City | FAIRBURN
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State | GA
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Zip | 30213-5800
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Country | US
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Telephone | 404-368-0702
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Fax |
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Authorized Official
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Title or Position | LPC/OWNER
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Name | SHELIA J. KEY
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Credential | LPC
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Telephone | 470-629-5424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | LPC009408
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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