Organization
THE RESTORATION HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS STARKS ADAMS (OWNER)
(480) 669-7660
Entity
Organization
Contact information
Practice address
3827 S 101ST DR, TOLLESON, AZ 85353-4138
(480) 669-7660
Mailing address
9301 W RASCON LOOP, PHOENIX, AZ 85037-6310
(480) 669-7660
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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