Provider Demographics
NPI:1932976420
Name:RESTORING LIVES LLC
Entity Type:Organization
Organization Name:RESTORING LIVES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRUEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-419-0595
Mailing Address - Street 1:2340 PASEO DEL PRADO STE D303
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4342
Mailing Address - Country:US
Mailing Address - Phone:702-419-0595
Mailing Address - Fax:
Practice Address - Street 1:2340 PASEO DEL PRADO STE D303
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4342
Practice Address - Country:US
Practice Address - Phone:702-419-0595
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?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness