Restoration Community Development Corp.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RESTORATION COMMUNITY DEVELOPMENT CORP.

Doing business as

Restoration Children Facilities

Practice address

500 CC Road
Belzoni, MS 39038

Phone

(662) 303-1800

NPI assigned

Oct 12, 2023

Last updated

Oct 12, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

RESTORATION COMMUNITY DEVELOPMENT CORP FACILITIESAs reported in NPPES

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

Authorized official

Name

Joann Wilson

Title

Director

Phone

(662) 303-1800

Specialties & licenses 3

Addresses

Other names 1

• Restoration Children Facilities Doing business as

Part of

Restoration Community Development Corp

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1821879156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CAMELLIA LN",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512604",
            "telephone_number": "662-303-1800",
            "fax_number": "662-399-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CC ROAD",
            "city": "BELZONI",
            "state": "MS",
            "postal_code": "39038",
            "telephone_number": "662-303-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION COMMUNITY DEVELOPMENT CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RESTORATION COMMUNITY DEVELOPMENT CORP FACILITIES",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "662-303-1800"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Restoration Children Facilities",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Baylee Richardson, PA-C
• Rise Up Facilities
• Rise Up Facilities
• Monica Victoria Robinson

• Community/Behavioral Health Agency in Belzoni, MS
• Providers in Belzoni, MS by specialty
• Community/Behavioral Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.