RESTORE HEALTH FAMILY PRACTICE NPI 1295312288

NPI Information

NPI: 1295312288
Provider Name: RESTORE HEALTH FAMILY PRACTICE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 06D2220005

Address:
1235 LAKE PLAZA DR STE 220
COLORADO SPRINGS, CO
ZIP 80906
Phone: (719) 292-5051
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RESTORE HEALTH FAMILY PRACTICE is a primary care clinic center in Colorado Springs, CO. RESTORE HEALTH FAMILY PRACTICE NPI is 1295312288. The provider is registered as an organization entity type.

The provider's business location address is:

1235 LAKE PLAZA DR STE 220
COLORADO SPRINGS, CO
ZIP 80906-556
Phone: (719) 292-5051
Fax: (719) 306-0183

The provider's authorized official is Aleathia Ware .
The authorized official title is Owner/operator and has the following contact phone number (719) 292-5051.

The CLIA number assigned to this NPI record is 06D2220005 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/25/2021 and was last updated on 12/5/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	91224560	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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