| Restore Behavioral Services Llc. | |
|
1919 Commerce Dr Ste 230 Hampton VA 23666-4269 | |
| (757) 509-4894 | |
| Not Available |
| Full Name | Restore Behavioral Services Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1919 Commerce Dr Ste 230, Hampton, Virginia |
| Authorized Official Name and Position | Dominique Washington-smith (CEO/OWNER) |
| Authorized Official Contact | 7575094984 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Behavioral Services Llc. Po Box 9112 Hampton VA 23670-0112 Ph: (757) 509-4984 | Restore Behavioral Services Llc. 1919 Commerce Dr Ste 230 Hampton VA 23666-4269 Ph: (757) 509-4894 |
| NPI Number | 1104523968 |
|---|---|
| Provider Enumeration Date | 02/13/2023 |
| Last Update Date | 09/19/2023 |
| Certification Date | 09/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104523968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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