Provider Demographics
NPI:1508407677
Name:RESTORING HOPE LLC
Entity Type:Organization
Organization Name:RESTORING HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:219-801-6453
Mailing Address - Street 1:2254 SAINT JOSEPH LN
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-5449
Mailing Address - Country:US
Mailing Address - Phone:219-801-6453
Mailing Address - Fax:
Practice Address - Street 1:2254 SAINT JOSEPH LN
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-5449
Practice Address - Country:US
Practice Address - Phone:219-801-6453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health