Provider Demographics
NPI:1487276200
Name:FAMILY RESTORATION SERVICES
Entity type:Organization
Organization Name:FAMILY RESTORATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADETOKUNBOH
Authorized Official - Middle Name:
Authorized Official - Last Name:AFONJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-251-6376
Mailing Address - Street 1:701 HOWMET DR STE 160
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-1001
Mailing Address - Country:US
Mailing Address - Phone:757-251-6376
Mailing Address - Fax:757-788-8599
Practice Address - Street 1:701 HOWMET DR STE 160
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-1001
Practice Address - Country:US
Practice Address - Phone:757-251-6376
Practice Address - Fax:757-788-8599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health