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General NPI Number Information
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NPI Number | 1558236737
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Entity Type | Organization
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Legal Business Name | THE RESTORA PSYCHIATRY LLC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 6500 WOODLAKE VILLAGE CIR
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-2200
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Country | US
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Telephone | 701-989-2057
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Fax |
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Provider Business Mailing Address
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Address Line | 6500 WOODLAKE VILLAGE CIR
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-2200
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Country | US
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Telephone | 701-989-2057
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LUCY UKACHUKWU
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Credential |
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Telephone | 701-989-2057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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