Provider Demographics
NPI:1568723799
Name:HOPE AND RESTORATION
Entity Type:Organization
Organization Name:HOPE AND RESTORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:TILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-574-3870
Mailing Address - Street 1:3514 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-2619
Mailing Address - Country:US
Mailing Address - Phone:910-574-3870
Mailing Address - Fax:910-574-3870
Practice Address - Street 1:3514 CLEARWATER DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-2619
Practice Address - Country:US
Practice Address - Phone:910-574-3870
Practice Address - Fax:910-574-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health