Provider Demographics
NPI:1023865326
Name:KINDFUL RESTORATION
Entity type:Organization
Organization Name:KINDFUL RESTORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:B
Authorized Official - Last Name:RODRIGUEZ BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:SUD/CHW
Authorized Official - Phone:951-934-8183
Mailing Address - Street 1:7344 MAGNOLIA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3819
Mailing Address - Country:US
Mailing Address - Phone:805-622-7747
Mailing Address - Fax:
Practice Address - Street 1:7344 MAGNOLIA AVE STE 110
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-3819
Practice Address - Country:US
Practice Address - Phone:951-404-0856
Practice Address - Fax:951-755-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children