Provider Demographics
NPI:1114116324
Name:RESTORATION SOCIETY, INC.
Entity Type:Organization
Organization Name:RESTORATION SOCIETY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUASTAFERRO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:716-832-2141
Mailing Address - Street 1:66 ENGLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1235
Mailing Address - Country:US
Mailing Address - Phone:716-832-2141
Mailing Address - Fax:716-832-0021
Practice Address - Street 1:327 ELM ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1634
Practice Address - Country:US
Practice Address - Phone:716-884-5216
Practice Address - Fax:716-884-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable