RESTORATION CLINIC NPI 1205248796

NPI Information

NPI: 1205248796
Provider Name: RESTORATION CLINIC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 44D2079983

Address:
17619 STATE HIGHWAY 58 N STE C
DECATUR, TN
ZIP 37322
Phone: (423) 506-3781
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RESTORATION CLINIC is a rural health clinic center in Decatur, TN. RESTORATION CLINIC NPI is 1205248796. The provider is registered as an organization entity type.

The provider's business location address is:

17619 STATE HIGHWAY 58 N STE C
DECATUR, TN
ZIP 37322-882
Phone: (423) 506-3781

The provider's authorized official is English Paige Roberts .
The authorized official title is Owner and has the following contact phone number (423) 506-3781.

The CLIA number assigned to this NPI record is 44D2079983 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/2/2014 and was last updated on 4/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	TENNESSEE	Yes
2	363LF0000X	Nurse Practitioner	Family		No
3	363LP2300X	Nurse Practitioner	Primary Care		No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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