RESTORE HEALTH CLINIC - NPI 1699140152 - Clinic/Center in Jackson, MS

Q: What is Restore Health PLLC's NPI number?

The NPI number for Restore Health PLLC is 1699140152. It was assigned to this organization in the NPPES registry on December 9, 2015. The provider is doing business as Restore Health Clinic.

Q: What is Restore Health PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

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About Restore Health Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RESTORE HEALTH CLINIC (NPI 1699140152) is a healthcare organization registered as a primary care in Jackson, Mississippi and active in the NPI registry since December 2015. The organization lists Shinita Reed Dudley, Owner, as its authorized official.

NPPES Registry Identity

NPI1699140152

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameRESTORE HEALTH PLLC

Location Address1551 E COUNTY LINE RDJackson, MS 39211-1801

Mailing Address1551 E County Line RdJackson, MS 39211-1801 · (601) 957-7343 · Fax (601) 957-7344

Phone(601) 957-7343

Fax(601) 957-7344

Organization SubpartNo

Authorized OfficialShinita Reed DudleyOwner · (601) 957-7343

Enumeration DateDecember 9, 2015

Last NPPES UpdateApril 8, 2016

✔ NPI 1699140152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

License✔ Licensed in MS · 18239

1551 E COUNTY LINE RD, Jackson, MS 39211

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Other Names 1

Doing Business AsRestore Health Clinic

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY BRYAN HICKMAN LPC

Counselor (Professional)