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Organization
RESTORE LIFE SERVICES, LLC
Active
Organization
RESTORE LIFE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEFAWN SPEIGHT (CLINICAL DIRECTOR/THERAPIST)
(301) 628-6140
Entity
Organization
Contact information
Practice address
4625 G ST SE, WASHINGTON, DC 20019-7834
(301) 628-6140
Mailing address
12813 LAMPTON LN, FORT WASHINGTON, MD 20744-5314
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
NULL
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
Other
Enumeration date
06/13/2017
Last updated
06/13/2017
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