THE RESTORATION VILLAGE: THERAPEUTIC AND HOLISTIC SERVICES (NPI# 1679047039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679047039 |
| Entity Type | Organization |
| Organization Name | THE RESTORATION VILLAGE: THERAPEUTIC AND HOLISTIC SERVICES |
| Practice Address |
149 Martin Luther King Jr Blvd N Pontiac MI 48342-2514 |
| Mailing Address |
2040 Beverly St Sylvan Lake MI 48320-1508 |
| Practice Telephone | 2488422310 |
| Mailing Telephone | 2488422310 |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2019-01-17 |
| Authorized Official Name | STACEY GIBSON (CEO) |
| Authorized Official Telephone | 2488422310 |
| Authorized Official Credential | LPC, DP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
149 MARTIN LUTHER KING JR BLVD N |
| City | PONTIAC |
| State | MI |
| Zip Code | 48342-2514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528589561 | Beloved Home Care LLC. | Home Health | 12 S Mill. St., Apt.314, Pontiac, MI 48342 | 2017-06-29 |
| 1518496942 | Boris Tkach | Student in an Organized Health Care Education/Training Program | 50 N. Perry, Pontiac, MI 48342 | 2017-06-08 |
| 1023547429 | Nicholas James Stepanski | Student in an Organized Health Care Education/Training Program | 50 N. Perry St., Pontiac, MI 48342 | 2017-06-08 |
| 1245769991 | Mecca House Corporation | Assisted Living Facility | 53 West Huron, Pontiac, MI 48342 | 2017-06-07 |
| 1134672868 | Shannon Blaine | Technician, Other | 103 Parkhurst Street, Pontiac, MI 48342 | 2016-07-29 |
| 1669819249 | Bonnie Ann Smith | Occupational Therapist | 60 Parkhurst Dr., Pontiac, MI 48342 | 2013-05-23 |
| 1205123361 | Mary Ellen Kenworthy | Emergency Medicine | 50 North Perry Street, Pontiac, MI 48342 | 2011-07-08 |
| 1740516343 | Nathima Habib Atchoo | Obstetrics & Gynecology | 90 West University, Gary Burnstein Community Health Clinic (free Clinic), Pontiac, MI 48342 | 2009-11-02 |
| 1881824233 | Sylvia Lyn Thompson | Physical Therapist | 900 Auburn Road, Pontiac, MI 48342 | 2009-07-20 |
| 1114154150 | Kyannah Toyann Anderson | Home Health | 175 S.edith St, Pontiac, MI 48342 | 2009-06-17 |
| Find all providers in zip 48342 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083160790 | Kim Kory Young | Counselor | 116 N Johnson St, Pontiac, MI 48341-1330 | 2016-09-01 |
| 1497165211 | Barbara Kay Browning | Counselor | 310 E. Torrance Ave, Pontiac, IL 61764 | 2014-05-01 |
| 1689842775 | Janice Lee | Counselor | 534 Franklin Rd, Pontiac, MI 48341-2527 | 2008-02-12 |
| 1699963074 | John Brownlee Moir | Counselor | 91 N. Saginaw St., Suite G 101, Pontiac, MI 48342 | 2007-10-10 |
| 1548450430 | Alejandra Alma-zapata | Counselor | 35 W Huron St Ste 500, Pontiac, MI 48342-2125 | 2007-07-27 |
| 1861603417 | Michael O'brien | Counselor | 36 W Tennyson Ave, Pontiac, MI 48340-2668 | 2007-05-25 |
| 1912533266 | David Anthony Dudek | Counselor | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2020-03-19 |
| 1477106003 | Kevin Steidinger | Counselor | 310 E Torrance Ave, Pontiac, IL 61764-2748 | 2019-07-23 |
| 1891262879 | Stacie Nicole Burns I | Counselor | 239 State St, Pontiac, MI 48341-1363 | 2018-10-29 |
| 1982187589 | Rachel Marie Guzman | Counselor | 239 State St, Pontiac, MI 48341-1363 | 2018-09-10 |
| Find all providers in PONTIAC | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.