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Organization
RESTART LIFE, PLLC
Active
Organization
RESTART LIFE, PLLC
Active
Other names
Restart Internet Addiction Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
COSETTE DAWNA RAE MSW (CEO)
(800) 682-6934
Entity
Organization
Contact information
Practice address
26509 NE VIRGINIA ST, DUVALL, WA 98019-6210
(800) 682-6934
(888) 788-3419
Mailing address
1001 290TH AVE SE, FALL CITY, WA 98024-7403
(800) 682-6934
(888) 788-3419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
LH60152285
WA
1041C0700X
Clinical Social Worker
—
WA
163W00000X
Registered Nurse
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/04/2012
Last updated
06/25/2025
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