Organization
RESTORATION FOR LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATAMERIA DONTA MCNAIR EVANGELIST (CEO)
(336) 895-6128
Entity
Organization
Contact information
Practice address
2301 W MEADOWVIEW RD STE 110, GREENSBORO, NC 27407-3704
(336) 895-6128
Mailing address
2301 W MEADOWVIEW RD STE 110, GREENSBORO, NC 27407-3704
(336) 895-6128
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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