Restorative Self, Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

RESTORATIVE SELF, INC

Practice address

126 W Solomon St
Griffin, GA 30223-3045

Phone

(424) 367-8313

NPI assigned

Feb 5, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jim Benson

Title

Legal Liason

Phone

(504) 621-5494

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549324800000",
    "number": "1487119335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 BENT TREE CT",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 W SOLOMON ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302233045",
            "telephone_number": "424-367-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE SELF, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "LEGAL LIASON",
        "authorized_official_telephone_number": "504-621-5494"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.