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LIFE RESTORATION CENTER
NPI 1417209917
Counselor - Professional in Troy, MO

Active since October 08, 2012
124 WILD TURKEY LN, TROY, MO 63379(636) 358-6021(636) 338-4911 Get Directions Write a Review

NPPES record last updated: October 8, 2012. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Life Restoration Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE RESTORATION CENTER (NPI 1417209917) is a healthcare organization registered as a professional in Troy, Missouri and active in the NPI registry since October 2012. The organization lists Samantha Lee Graham-douglas, President, as its authorized official.

NPPES Registry Identity

NPI1417209917
Entity TypeOrganization
Primary Taxonomy101YP2500X
Legal Business NameLIFE RESTORATION CENTER
Location Address124 WILD TURKEY LNTroy, MO 63379-4339
Mailing Address124 Wild Turkey LnTroy, MO 63379-4339 · (636) 358-6021 · Fax (636) 338-4911
Phone(636) 358-6021
Fax(636) 338-4911
Organization SubpartNo
Authorized OfficialSamantha Lee Graham-douglasPresident · (636) 358-6021
Enumeration DateOctober 8, 2012
✔ NPI 1417209917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MO · 2007035322
124 WILD TURKEY LN, Troy, MO 63379
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Other Identifiers 1

Medicaid1538337159MO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Restoration Center's NPI number?

The NPI number for Life Restoration Center is 1417209917. It was assigned to this organization in the NPPES registry on October 8, 2012.

Where is Life Restoration Center located?

Life Restoration Center is located at 124 Wild Turkey Ln, Troy, MO 63379. The listed phone number is (636) 358-6021.

What is Life Restoration Center's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Life Restoration Center was last updated on October 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.