A Restored Outlook LLC

Key facts

NPI

1124663935

Entity type

Organization (NPI type 2)

Primary specialty

Clinical Social Worker 1041C0700X

Legal business name

A RESTORED OUTLOOK LLC

Practice address

8287 Linda St
Warren, MI 48093-2838

Phone

(313) 918-8304

NPI assigned

Nov 15, 2019

Organization subpart

No

Authorized official

Name

Mr. Michael J Dubose, LLMSW NPI 1265977128

Title

Ceo

Phone

(586) 344-0748

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Dubose Social Worker · Sterling Heights, MI · NPI 1265977128
  NPD Authorized official CLINICAL

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 15, 2019.

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1124663935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8287 LINDA ST",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932838",
            "telephone_number": "586-344-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8287 LINDA ST",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932838",
            "telephone_number": "313-918-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A RESTORED OUTLOOK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "DUBOSE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "586-344-0748",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LLMSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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