Provider Demographics
NPI:1982498838
Name:RESTORING LIFE INC
Entity type:Organization
Organization Name:RESTORING LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:KIERRIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-408-9880
Mailing Address - Street 1:2620 CHIPCO ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-1431
Mailing Address - Country:US
Mailing Address - Phone:813-408-9880
Mailing Address - Fax:
Practice Address - Street 1:2620 CHIPCO ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605-1431
Practice Address - Country:US
Practice Address - Phone:813-408-9880
Practice Address - Fax:813-408-9880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services