Provider Demographics
NPI:1972962215
Name:RESTORATION MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:RESTORATION MENTAL HEALTH SERVICES
Other - Org Name:JOHN E ISRAEL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ISRAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-867-5905
Mailing Address - Street 1:4614 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-6312
Mailing Address - Country:US
Mailing Address - Phone:832-867-5905
Mailing Address - Fax:210-362-1824
Practice Address - Street 1:4614 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-6312
Practice Address - Country:US
Practice Address - Phone:832-867-5905
Practice Address - Fax:210-362-1824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty