Organization
RELEASE TO RESTORE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWANDA BENTON (LPC)
(225) 317-9383
Entity
Organization
Contact information
Practice address
717 S FOSTER DR, STE. 130, BATON ROUGE, LA 70806-5943
(225) 317-9383
(225) 341-1217
Mailing address
PO BOX 65262, BATON ROUGE, LA 70896-5262
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5070
LA
Other
Enumeration date
09/27/2014
Last updated
09/27/2014
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