Provider Demographics
NPI:1619474335
Name:RESTORATION CARE AND COUNSELING LLC
Entity Type:Organization
Organization Name:RESTORATION CARE AND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-650-5195
Mailing Address - Street 1:1557 SHERMAN AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4836
Mailing Address - Country:US
Mailing Address - Phone:847-650-5195
Mailing Address - Fax:888-965-7208
Practice Address - Street 1:1557 SHERMAN AVE STE 5
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4836
Practice Address - Country:US
Practice Address - Phone:847-650-5195
Practice Address - Fax:888-965-7208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty