MEDICARE: RESTORING FAMILIES ONE STEP AT A TIME, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1356808521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORING FAMILIES ONE STEP AT A TIME, LLC

Provider Business Mailing Address
First Line	:	6201 LA PAS TRL STE 285
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-4869
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 LA PAS TRL STE 285
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-4869
Country	:	US
Telephone Number	:	317-610-1417
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	REGINA BARNETT-JOHNSON
Credential	:
Telephone Number	:	317-610-1417

Provider Enumeration Date	:	02/25/2019
Last Update Date	:	02/25/2019

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