Provider Demographics
NPI:1992550149
Name:REST STOP THERAPY
Entity type:Organization
Organization Name:REST STOP THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TONDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHILDERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-956-7719
Mailing Address - Street 1:2101 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-6705
Mailing Address - Country:US
Mailing Address - Phone:704-956-7719
Mailing Address - Fax:704-559-3826
Practice Address - Street 1:140 CABARRUS AVE W STE 19
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5150
Practice Address - Country:US
Practice Address - Phone:704-956-7719
Practice Address - Fax:704-559-3826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health