Provider Demographics
NPI:1760177976
Name:RESTORE PSYCHIATRIC CARE, LLC
Entity Type:Organization
Organization Name:RESTORE PSYCHIATRIC CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-989-0079
Mailing Address - Street 1:100 POWELL PL # 1190
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3622
Mailing Address - Country:US
Mailing Address - Phone:615-989-0799
Mailing Address - Fax:
Practice Address - Street 1:700 CRAIGHEAD ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2254
Practice Address - Country:US
Practice Address - Phone:615-989-0799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty