Healthcare Provider Details

I. General information

NPI: 1881376432
Provider Name (Legal Business Name): RESTORED FOR LIFE RECOVERY CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1679 N HIGHWAY 7
HOT SPRINGS VILLAGE AR
71909-9310
US

IV. Provider business mailing address

1679 N HIGHWAY 7
HOT SPRINGS VILLAGE AR
71909-9310
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-2446
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA KATE RIGGS
Title or Position: COO
Credential: MBA
Phone: 479-264-7696