Provider Demographics
NPI:1750927372
Name:RESTORING HOPE - HEALING FROM TRAUMA AND ADDICTION
Entity type:Organization
Organization Name:RESTORING HOPE - HEALING FROM TRAUMA AND ADDICTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LEREIGH
Authorized Official - Last Name:WHITEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:208-571-8459
Mailing Address - Street 1:PO BOX 1662
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83680-1662
Mailing Address - Country:US
Mailing Address - Phone:208-571-8459
Mailing Address - Fax:208-315-6718
Practice Address - Street 1:1407 W MCMILLAN RD STE 120
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-5168
Practice Address - Country:US
Practice Address - Phone:208-315-6717
Practice Address - Fax:208-315-6718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health