Life Restoration Center

NPI #1417209917 in Troy, Missouri

Provider Information

NPI Number: 1417209917
Entity Type: Organization
Organization Name: Life Restoration Center
Primary Specialty: Counselor - Professional
Enumeration Date: Oct 8, 2012
Last Updated: Oct 8, 2012

Practice Location

Address: 124 WILD TURKEY LN
City: Troy
State: Missouri
ZIP Code: 63379-4339
Phone: (636) 358-6021

Authorized Official

Name: MRS. SAMANTHA LEE GRAHAM-DOUGLAS, LPC
Title: PRESIDENT
Phone: (636) 358-6021

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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