NPIMap

Organization Active NPI

Restore Hope of Jensen Beach LLC

Doing business as Restore Hope LLC

  • Substance Abuse Rehabilitation Facility
  • Stuart, FL
National Provider Identifier
1619422763
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RESTORE HOPE OF JENSEN BEACH LLC
Doing business as
Restore Hope LLC
Practice address
1320 SE Federal Hwy Ste 105
Stuart, FL 34994-3409
Phone
(772) 444-7388
Fax
(772) 444-7388
NPI assigned
Aug 18, 2016
Last updated
Jul 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Authorized official

Name
Jose Juan Diaz, DONPI 1164535753
Title
Medical Director
Phone
(772) 444-7388

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Recovery Care Clinic/Center 261QR0800X NU
Substance Abuse Rehabilitation Facility 324500000X NU Primary
Counselor 101Y00000X NU

Addresses

Primary practice location

1320 SE Federal Hwy Ste 105
Stuart, FL 34994-3409

Mailing address

1320 SE Federal Hwy Ste 105
Stuart, FL 34994-3409
Phone (772) 444-7388

Other names 1

  • Restore Hope LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Restore Hope LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1619422763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 SE FEDERAL HWY STE 105",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943409",
            "telephone_number": "772-444-7388",
            "fax_number": "772-444-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 SE FEDERAL HWY STE 105",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943409",
            "telephone_number": "772-444-7388",
            "fax_number": "772-444-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE HOPE OF JENSEN BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "JUAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "772-444-7388",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restore Hope LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.