| Restored Life Counseling | |
|
930 Wingate St Ste D2 Conway AR 72034-4837 | |
| (501) 499-8699 | |
| (501) 205-4588 |
| Full Name | Restored Life Counseling |
|---|---|
| Speciality | Counselor - Professional |
| Location | 930 Wingate St Ste D2, Conway, Arkansas |
| Authorized Official Name and Position | Tresvil Gerard Pack (PRESIDENT/CEO) |
| Authorized Official Contact | 5014998699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restored Life Counseling Po Box 11770 Conway AR 72034-0031 Ph: (501) 499-8699 | Restored Life Counseling 930 Wingate St Ste D2 Conway AR 72034-4837 Ph: (501) 499-8699 |
| NPI Number | 1194076737 |
|---|---|
| Provider Enumeration Date | 09/23/2012 |
| Last Update Date | 11/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194076737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | P1101006 (Arkansas) | Primary |
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