Restore U Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

SW 13121 Issued in FL

Legal business name

RESTORE U INC.

Practice address

3005 Lithia Pinecrest Rd
Valrico, FL 33596-5630

Phone

(813) 495-6702

Fax

(813) 425-5739

NPI assigned

Jan 16, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Islaine St.Vil, MSW,LCSW

Title

Licensed Clinical Social Worker

Phone

(813) 495-6702

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1484524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484524800000",
    "number": "1639615537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 LITHIA PINECREST RD",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335965630",
            "telephone_number": "813-495-6702",
            "fax_number": "813-425-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 LITHIA PINECREST RD",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335965630",
            "telephone_number": "813-495-6702",
            "fax_number": "813-425-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE U INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-16",
        "last_updated": "2017-01-16",
        "status": "A",
        "authorized_official_last_name": "ST.VIL",
        "authorized_official_first_name": "ISLAINE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "813-495-6702",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW,LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "SW 13121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017869000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Valrico, FL
• Providers in Valrico, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; 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.