Provider Demographics
NPI:1144774845
Name:RESTORING THE SOUL, INC.
Entity Type:Organization
Organization Name:RESTORING THE SOUL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-932-9777
Mailing Address - Street 1:PO BOX 150545
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-0545
Mailing Address - Country:US
Mailing Address - Phone:303-932-9777
Mailing Address - Fax:
Practice Address - Street 1:9200 W CROSS DR STE 650
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-0763
Practice Address - Country:US
Practice Address - Phone:303-932-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty