Provider Demographics
NPI:1750536041
Name:RESTORATIVE BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:RESTORATIVE BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, PLCSW
Authorized Official - Phone:919-995-9284
Mailing Address - Street 1:225 WEATHERS CT
Mailing Address - Street 2:STE109, #25
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-7852
Mailing Address - Country:US
Mailing Address - Phone:919-283-5444
Mailing Address - Fax:919-283-5280
Practice Address - Street 1:88 WHEATON DR
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596-8691
Practice Address - Country:US
Practice Address - Phone:919-283-5444
Practice Address - Fax:919-283-5280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty