Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Life Restoration Center

Organization Professional Counselor · NPI 1417209917

Life Restoration Center is a Professional Counselor in Troy, Missouri. Licensed in Missouri. Registered with an NPI since 2012.

Licensed in
MO
In the registry since
2012

Practice location Address checks out

124 Wild Turkey Ln
Troy, MO 63379-4339
Phone: (636) 358-6021
Fax: (636) 338-4911
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 2007035322 (MO)

Record details

NPI number1417209917
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Samantha Graham-Douglas — President · (636) 358-6021
NPI enumeratedOctober 8, 2012
Last updated in NPPESOctober 8, 2012
Mailing address124 Wild Turkey Ln, Troy, MO 63379-4339

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