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Organization

RESTORATION HOUSE MINISTRIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW JOHNSON M.A., M.DIV (CEO)
(865) 805-0567
Entity
Organization

Contact information

Practice address
2450 WINFIELD DUNN PKWY, KODAK, TN 37764-2100
(865) 805-0567
Mailing address
2450 WINFIELD DUNN PKWY, KODAK, TN 37764-2100

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
207QA0401X
Addiction Medicine (Family Medicine) Physician
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
276400000X
Substance Use Disorder Rehabilitation Hospital Unit

Other

Enumeration date
09/15/2022
Last updated
02/28/2024
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