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General NPI Number Information
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NPI Number | 1437648086
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Entity Type | Organization
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Legal Business Name | RESTORATION BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 615 N BIRDNECK RD STE 109
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6368
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Country | US
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Telephone | 757-754-9947
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5877
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City | VIRGINIA BEACH
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State | VA
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Zip | 23471-0877
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | TIFFINEY THOMPSON
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Credential | DNP
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Telephone | 757-754-9947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024169409
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License Number State | VA
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