Provider Demographics
NPI:1942766225
Name:RESTORING HEALTH CLINIC LLC
Entity Type:Organization
Organization Name:RESTORING HEALTH CLINIC LLC
Other - Org Name:BELINDA A CAVER-BALLARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAVER-BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:931-272-2446
Mailing Address - Street 1:2237 LOWES DR W STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6891
Mailing Address - Country:US
Mailing Address - Phone:931-272-2446
Mailing Address - Fax:855-530-6144
Practice Address - Street 1:2237 LOWES DR W STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6891
Practice Address - Country:US
Practice Address - Phone:931-272-2446
Practice Address - Fax:855-530-6144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ038084Medicaid
TNQ049160Medicaid