Provider Demographics
NPI:1932723210
Name:RBC-RESTORATIVE BRAIN, INC.
Entity type:Organization
Organization Name:RBC-RESTORATIVE BRAIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DURBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-799-7996
Mailing Address - Street 1:15727 HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-1610
Mailing Address - Country:US
Mailing Address - Phone:816-799-7996
Mailing Address - Fax:816-934-4161
Practice Address - Street 1:1010 CARONDELET DR STE 112
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4821
Practice Address - Country:US
Practice Address - Phone:866-695-2867
Practice Address - Fax:816-934-4161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty