Provider Demographics
NPI:1093465585
Name:RESTORATION THERAPY LLC
Entity Type:Organization
Organization Name:RESTORATION THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:HADFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-622-1690
Mailing Address - Street 1:4150 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3724
Mailing Address - Country:US
Mailing Address - Phone:231-622-1690
Mailing Address - Fax:
Practice Address - Street 1:3301 VETERANS DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4574
Practice Address - Country:US
Practice Address - Phone:231-412-4842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty