Provider Demographics
NPI:1386873362
Name:RESTORATION MBS CENTER,INC.
Entity type:Organization
Organization Name:RESTORATION MBS CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR 1
Authorized Official - Prefix:MS
Authorized Official - First Name:CORNELL
Authorized Official - Middle Name:G
Authorized Official - Last Name:BADETTE
Authorized Official - Suffix:
Authorized Official - Credentials:CADC
Authorized Official - Phone:630-660-6308
Mailing Address - Street 1:1127 S MANNHEIM RD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2570
Mailing Address - Country:US
Mailing Address - Phone:708-483-8320
Mailing Address - Fax:708-483-8321
Practice Address - Street 1:1127 S MANNHEIM RD
Practice Address - Street 2:SUITE 216
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2570
Practice Address - Country:US
Practice Address - Phone:708-483-8320
Practice Address - Fax:708-483-8321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-3821-0001-A103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty