# RESTOR8TION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477110831
- **Authorized official:** MS. ARDELLE MICHELLE MOORE LISW-S, LICDC-CS (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (216) 849-3390

## Contact information

- **Practice address:** 3631 PERKINS AVE, CLEVELAND, OH 44114-4705
- **Practice address phone:** (216) 849-3390
- **Mailing address:** 815 FROST RD APT 1001, STREETSBORO, OH 44241-4735
- **Mailing address phone:** (216) 849-3390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 05/21/2019
- **Last updated:** 05/21/2019