RESTORE ADDICTION RECOVERY AND WELLNESS LLC NPI 1144973116

NPI Information

NPI: 1144973116
Provider Name: RESTORE ADDICTION RECOVERY AND WELLNESS LLC
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
613 BURROUGHS ST
MORGANTOWN, WV
ZIP 26505
Phone: (724) 825-5527
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RESTORE ADDICTION RECOVERY AND WELLNESS LLC is an addiction medicine family medicine in Morgantown, WV. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. RESTORE ADDICTION RECOVERY AND WELLNESS LLC NPI is 1144973116. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

613 BURROUGHS ST
MORGANTOWN, WV
ZIP 26505-332
Phone: (724) 825-5527

The provider's authorized official is Travis L Watson .
The authorized official title is Executive Director and has the following contact phone number (724) 825-5527.

The enumeration date for this NPI number is 1/31/2022 and was last updated on 1/31/2022.

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 Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	170	OTHER	WEST VIRGINIA	STATE OF WV

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: 11/14/2023

NPI Synchronization or Removal

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