RESTORED LIFE SERVICES OF ARKANSAS (NPI# 1558727024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558727024 |
| Entity Type | Organization |
| Organization Name | RESTORED LIFE SERVICES OF ARKANSAS |
| Other Organization Name | RESTORED LIFE SERVICES |
| Practice Address |
127 E 3rd St Russellville AR 72801-5106 |
| Mailing Address |
Po Box 1483 Russellville AR 72811-1483 |
| Practice Telephone | 4792194100 |
| Mailing Telephone | 4792194100 |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-28 |
| Authorized Official Name | MRS. MARY CAITLIN CONNER (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 4792194100 |
| Authorized Official Credential | L.A.D.A.C., C.R. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Restored Life Services | Other Name - Individual/Organization |
| Street Address |
127 E 3RD ST |
| City | RUSSELLVILLE |
| State | AR |
| Zip Code | 72801-5106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002782 | Randy Paul Stayton | Pharmacist | 2109 W Main, Russellville, AR 72801 | 2020-10-30 |
| 1871134825 | Just Spreading Love Senior Care LLC | Student in an Organized Health Care Education/Training Program | 1411 N. Pittsburg Avenue, Russellville, AR 72801 | 2019-10-01 |
| 1124670369 | Richard L Morgan Dds Pa | Dentist | 1700 West C Place, Russellville, AR 72801 | 2019-07-09 |
| 1407342371 | Andrew James Hickman | Optometrist | 2711 E Parkway Drive, Russellville, AR 72801 | 2018-07-03 |
| 1154859833 | Felicia Head | Speech-Language Pathologist | 220 W 10th St., Russellville, AR 72801 | 2017-05-25 |
| 1295281293 | Arkansas Liver and Gastroenterology, P.a. | Internal Medicine | 1605 West Main Street, Russellville, AR 72801 | 2016-08-30 |
| 1467802405 | Kah Development 4, LLC | Hospice Care, Community Based | 3801 W Main St Ste A, Russellville, AR 72801 | 2016-06-21 |
| 1871904839 | Sleep Partners, LLC | Clinic/Center | 1310 West B Street, Suite A, Russellville, AR 72801 | 2014-05-13 |
| 1942647029 | Rpi Sleep Complete LLC | Clinic/Center | 1310 West Main Street, Suite 201, Russellville, AR 72801 | 2013-05-29 |
| 1184967291 | Amedco Arkansas Pllc | Optometrist | 302 N. Phoenix Ave., Clark Eye Clinic, Russellville, AR 72801 | 2013-03-27 |
| Find all providers in zip 72801 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316587850 | Friends of Freedom House Inc. | Counselor | 404 Lake Front Drive, Russellville, AR 72802 | 2020-01-13 |
| 1831238468 | Edith Paulette Young | Counselor | 237 E 6th St, Russellville, KY 42276-1917 | 2007-02-06 |
| 1235208612 | Gail L Ungemach | Counselor | 1400 E 16th St, Russellville, AR 72801 | 2006-11-07 |
| 1891881108 | Alvin Jeffery Phillips | Counselor | 1110 W B St, Suite G, Russellville, AR 72801-3506 | 2006-10-05 |
| 1730168873 | Gretchen Suzanne Douthit | Counselor | 103 N Hastings Ave, Russellville, AR 72801-2425 | 2006-01-16 |
| 1649651852 | Grace Rideout | Counselor | 400 Lake Front Dr, Russellville, AR 72802-2206 | 2015-06-12 |
| 1750762969 | Tracy Humphrey | Counselor | 400 Lake Front Dr, Russellville, AR 72802-2206 | 2015-06-12 |
| 1770964975 | David Tucker | Counselor | 400 Lake Front Dr, Russellville, AR 72802-2206 | 2015-06-12 |
| 1023104338 | Phillip M Higdon | Counselor | 110 Skyline Drive, Russellville, AR 72801 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548870389 | Zabrina Zennile Weaver | Counselor | 407 W 35th Ave, Pine Bluff, AR 71603-6083 | 2020-08-06 |
| 1366051088 | Katreasa L Cwright | Counselor | 224 South 5th St, Madison, AR 72359 | 2020-07-28 |
| 1679100549 | Collin Roe | Counselor | 1200 W Walnut St Ste 1115, Rogers, AR 72756-3521 | 2020-03-23 |
| 1871158469 | Jerry Rushing | Counselor | 6301 Father Tribou St, Little Rock, AR 72205-3003 | 2019-05-08 |
| 1386113421 | Stephanie Jade Moore | Counselor | 1104 Vine Street, Batesville, AR 72501-8638 | 2018-11-19 |
| 1144705872 | The Family Institute of Arkansas | Counselor | 425 W Broadway St Ste H, North Little Rock, AR 72114-5576 | 2018-09-27 |
| 1023500634 | Carlotta A Powell | Counselor | 7000 N Stateline Ave, Texarkana, AR 71854 | 2018-05-31 |
| 1831680909 | Greg Dupriest | Counselor | 1239 Alma North St, Alma, AR 72921-4602 | 2018-05-24 |
| 1609366350 | Eric Dominic Parks | Counselor | 7000 N State Line Ave, Texarkana, AR 71854-8100 | 2018-05-17 |
| 1164882106 | Katelyn Coney | Counselor | 15 Trina Loop, Greenbrier, AR 72058-9062 | 2016-03-03 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELLVILLE |
| Zip Code | 72801 |
Please comment or provide details below to improve the information on RESTORED LIFE SERVICES OF ARKANSAS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.