| Restore Lyfe Llc | |
|
22 Chadwick Dr Stafford VA 22556-4622 | |
| (571) 501-7151 | |
| Not Available |
| Full Name | Restore Lyfe Llc |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 22 Chadwick Dr, Stafford, Virginia |
| Authorized Official Name and Position | Hannah Karen England (OWNER) |
| Authorized Official Contact | 5207099163 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Lyfe Llc 22 Chadwick Dr Stafford VA 22556-4622 Ph: (571) 501-7151 | Restore Lyfe Llc 22 Chadwick Dr Stafford VA 22556-4622 Ph: (571) 501-7151 |
| NPI Number | 1740002369 |
|---|---|
| Provider Enumeration Date | 10/25/2024 |
| Last Update Date | 10/25/2024 |
| Certification Date | 10/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740002369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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