Provider Demographics
NPI:1790552339
Name:RESTORED HOPE THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:RESTORED HOPE THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCCOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLC
Authorized Official - Phone:989-205-2926
Mailing Address - Street 1:121 E SUGNET RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-3623
Mailing Address - Country:US
Mailing Address - Phone:989-205-2926
Mailing Address - Fax:
Practice Address - Street 1:121 E SUGNET RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-3623
Practice Address - Country:US
Practice Address - Phone:989-205-2926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty