Organization
R.E.S.T.O.R.E. BEHAVIORAL HEALTH REHABILITATIVE TREATMENT SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RITA MICHELLE BLANKENSHIP MS, CADC-I (EXECUTIVE DIRECTOR/CEO)
(404) 449-3463
Entity
Organization
Contact information
Practice address
3925 NORTH MARTIN LUTHER KING BLVD., SUITE 215, NORTH LAS VEGAS, NV 89032-7676
(404) 449-3463
(702) 990-2063
Mailing address
3925 NORTH MARTIN LUTHER KING BLVD., SUITE 215, NORTH LAS VEGAS, NV 89032-7676
(404) 449-3463
(702) 990-2063
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
20111522035
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386923506
—
NV
Enumeration date
08/04/2011
Last updated
07/14/2014
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