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Organization
RESTART, INC
Active
Organization
RESTART, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS MITCHELL (CEO)
(252) 355-4725
Entity
Organization
Contact information
Practice address
3300 PINETREE LN, GREENVILLE, NC 27858-9293
(252) 355-4725
(252) 355-0444
Mailing address
498 RED BANKS RD # A, GREENVILLE, NC 27858-5704
(252) 355-4725
(252) 355-0444
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-074-149
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-074-166
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603991
—
NC
05
—
6604078
—
NC
05
—
8300389B
—
NC
05
—
8300389G
—
NC
05
—
8301850
—
NC
Enumeration date
01/11/2007
Last updated
04/25/2008
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