Organization
RESTORATION THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA WILLIAMS FORSYTHE MSW, LCSW, LCAS-A (OWNER)
(919) 333-5511
Entity
Organization
Contact information
Practice address
4006 PEACHTREE TOWN LN, KNIGHTDALE, NC 27545-7948
(919) 333-5511
Mailing address
4006 PEACHTREE TOWN LN, KNIGHTDALE, NC 27545-7948
(919) 333-5511
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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