Provider Demographics
NPI:1043504400
Name:RESTORING HEARTS MINISTRY
Entity Type:Organization
Organization Name:RESTORING HEARTS MINISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF OPERATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KNIGHTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-355-0201
Mailing Address - Street 1:1821 WOODDALE CT STE 121
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1535
Mailing Address - Country:US
Mailing Address - Phone:225-330-4479
Mailing Address - Fax:225-364-2765
Practice Address - Street 1:1821 WOODDALE CT STE 121
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1535
Practice Address - Country:US
Practice Address - Phone:225-330-4479
Practice Address - Fax:225-364-2765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization