RESTART LIFE PLLC NPI 1801166103

NPI Information

NPI: 1801166103
Provider Name: RESTART LIFE, PLLC

Other Name: RESTART INTERNET ADDICTION RECOVERY

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization

Address:
2002 156TH AVE NE
BELLEVUE, WA
ZIP 98007
Phone: (800) 682-6934
Get Directions

RESTART LIFE, PLLC is a community based residential treatment facility mental illness in Bellevue, WA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. RESTART LIFE, PLLC NPI is 1801166103. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Restart Internet Addiction Recovery.

The provider's business location address is:

2002 156TH AVE NE
BELLEVUE, WA
ZIP 98007
Phone: (800) 682-6934
Fax: (888) 788-3419

The provider's authorized official is Cosette Dawna Rae .
The authorized official title is Ceo and has the following contact phone number (800) 682-6934.

The CLIA number assigned to this NPI record is 50D2257427 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/4/2012 and was last updated on 4/19/2022.

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	101YM0800X	Counselor	Mental Health	LH60152285	WASHINGTON	No
2	101YM0800X	Counselor	Mental Health		WASHINGTON	No
3	1041C0700X	Social Worker	Clinical		WASHINGTON	No
4	163W00000X	Registered Nurse		RN00086253	WASHINGTON	No
5	251S00000X	Community/Behavioral Health				No
6	323P00000X	Psychiatric Residential Treatment Facility				No
7	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

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

NPI Synchronization or Removal

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