Organization
RESTORATIVE COUNSELING SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ELLORY WINSTON (CEO)
(313) 304-1120
Entity
Organization
Contact information
Practice address
29661 RED LEAF DR, SOUTHFIELD, MI 48076-2040
(313) 304-1120
(248) 443-6623
Mailing address
29661 RED LEAF DR, SOUTHFIELD, MI 48076-2040
(313) 304-1120
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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