Restored to New Life Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RESTORED TO NEW LIFE SERVICES, LLC

Practice address

225 E 11TH St Ste 206
Sioux Falls, SD 57104-6482

Phone

(605) 271-7712

Fax

(605) 274-1557

NPI assigned

Jan 22, 2020

Organization subpart

No

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

Authorized official

Name

Johnny Randle Ray Jr., LCSW-PIP, LAC, QMPHNPI 1487825261

Title

Owner/Therapist

Phone

(605) 271-7712

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Johnny R Ray Jr., LCSW-PIP, LAC, QMHP

  • Clinical Social Worker
  • Sioux Falls, SD
  • NPI 1487825261
  NPD Authorized official

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1508496258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 E 8TH ST STE 102",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571031865",
            "telephone_number": "605-271-7712",
            "fax_number": "605-274-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E 11TH ST STE 206",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571046482",
            "telephone_number": "605-271-7712",
            "fax_number": "605-274-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORED TO NEW LIFE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "RANDLE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "605-271-7712",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCSW-PIP, LAC, QMPH"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Sioux Falls, SD by specialty
• Community/Behavioral Health Agency in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.