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NPI Code Detail

MEDICARE: RESTORATION COUNSELING & COMMUNITY SERVICES, LLC

MEDICARE: RESTORATION COUNSELING & COMMUNITY SERVICES, 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
1251S00000XCommunity/Behavioral Health Agency1061726MN

General Provider Information

NPI Number : 1902183338
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESTORATION COUNSELING & COMMUNITY SERVICES, LLC
Provider Business Mailing Address
First Line : 1901 44TH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1209
Country : US
Telephone Number : 612-767-6601
Fax Number : 612-767-6603
Provider Business Practice Location Address
First Line : 1901 44TH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1209
Country : US
Telephone Number : 612-767-6601
Fax Number : 612-767-6603
Authorized Official
Title or Position : CEO
Name : MR. PAUL ANTHONY KUSTERMANN
Credential :
Telephone Number : 612-767-6601
Provider Enumeration Date : 11/14/2011
Last Update Date : 11/14/2011

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Directions to “RESTORATION COUNSELING & COMMUNITY SERVICES, LLC ” Practice Location

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