Organization
RESTORATIVE SELF, INC
Active
Organization
RESTORATIVE SELF, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM BENSON (LEGAL LIASON)
(504) 621-5494
Entity
Organization
Contact information
Practice address
126 W SOLOMON ST, GRIFFIN, GA 30223-3045
(424) 367-8313
Mailing address
204 BENT TREE CT, COVINGTON, LA 70433-4745
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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