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Organization

HOUSE OF RESTORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHNNIE CLIFTON ROBINSON JR. (EXECUTIVE DIRECTOR/ SOCIAL WORKER)
(334) 214-5522
Entity
Organization

Contact information

Practice address
1200 12TH CT, PHENIX CITY, AL 36867-5732
(334) 214-5522
(334) 214-5525
Mailing address
1200 12TH CT, PHENIX CITY, AL 36867-5732
(334) 214-5522
(334) 214-5525

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
02/26/2010
Last updated
02/26/2010
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