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General NPI Number Information
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NPI Number | 1881376432
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Entity Type | Organization
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Legal Business Name | RESTORED FOR LIFE RECOVERY CENTERS, INC.
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 1679 N HIGHWAY 7
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City | HOT SPRINGS VILLAGE
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State | AR
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Zip | 71909-9310
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Country | US
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Telephone | 501-624-2446
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Fax |
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Provider Business Mailing Address
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Address Line | 1679 N HIGHWAY 7
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City | HOT SPRINGS VILLAGE
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State | AR
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Zip | 71909-9310
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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 | COO
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Name | SAMANTHA KATE RIGGS
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Credential | MBA
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Telephone | 479-264-7696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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