Provider Demographics
NPI:1063275170
Name:HEALTHY RESTORATIVE PRACTICES, LLC
Entity type:Organization
Organization Name:HEALTHY RESTORATIVE PRACTICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:SHATIRIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-910-3212
Mailing Address - Street 1:2125 BISCAYNE BLVD # 275
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5031
Mailing Address - Country:US
Mailing Address - Phone:786-910-3212
Mailing Address - Fax:
Practice Address - Street 1:2125 BISCAYNE BLVD # 275
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5031
Practice Address - Country:US
Practice Address - Phone:786-910-3212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)