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RESTORATION RECOVERY PLLC NPI 1770011652


NPI Information

NPI: 1770011652
Provider Name: RESTORATION RECOVERY, PLLC
Classification: Preventive Medicine - 2083A0300X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 11D2159860

Address:
6141 SHALLOWFORD RD STE 100
CHATTANOOGA, TN
ZIP 37421
Phone: (423) 498-2000
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RESTORATION RECOVERY, PLLC is an addiction medicine preventive medicine in Chattanooga, TN. The provider is a physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction. RESTORATION RECOVERY, PLLC NPI is 1770011652. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6141 SHALLOWFORD RD STE 100
CHATTANOOGA, TN
ZIP 37421-663
Phone: (423) 498-2000
Fax: (423) 498-2001

The provider's authorized official is Michelle Paolucci .
The authorized official title is Facility Director and has the following contact phone number (423) 498-2005.

The CLIA number assigned to this NPI record is 11D2159860 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2017 and was last updated on 7/20/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
22083A0300XPreventive MedicineAddiction MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1003147609AMEDICAIDGEORGIA
2Q028699MEDICAIDTENNESSEE

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: 4/28/2024

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