Provider Demographics
NPI:1831481605
Name:TEAM RESTORATION MINISTRIES, LLC
Entity Type:Organization
Organization Name:TEAM RESTORATION MINISTRIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-238-9010
Mailing Address - Street 1:1473 195TH AVE
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-8222
Mailing Address - Country:US
Mailing Address - Phone:515-238-9010
Mailing Address - Fax:641-342-1017
Practice Address - Street 1:1473 195TH AVE
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-8222
Practice Address - Country:US
Practice Address - Phone:515-238-9010
Practice Address - Fax:641-342-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty