Restart Life, PLLC
Psychiatric Residential Treatment Facility in Duvall, WA. Organization (NPI-2).
NPI number1801166103
StatusActive
Last updated in NPPESJun 25, 2025
Details
- NPI
- 1801166103
- Entity type
- Organization (NPI-2)
- Legal business name
- Restart Life, PLLC
- Organization subpart
- No
- Enumeration date
- Jan 4, 2012
- Certification date
- Jun 25, 2025
- Last updated
- Jun 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 323P00000X | Psychiatric Residential Treatment Facility | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 101YM0800X | Counselor, Mental Health | LH60152285 | WA | |
| 101YM0800X | Counselor, Mental Health | – | WA | |
| 1041C0700X | Social Worker, Clinical | – | WA | |
| 163W00000X | Registered Nurse | – | – | |
| 251B00000X | Case Management | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – |
Other names
- Restart Internet Addiction Recovery (Other Name)
Practice location
26509 Ne Virginia StDuvall, WA 98019-6210
Phone 800-682-6934 · Fax 888-788-3419
Mailing address
1001 290th Ave SeFall City, WA 98024-7403
Phone 800-682-6934 · Fax 888-788-3419
Other practice locations
2002 156th Ave Ne Ste 100
Bellevue, WA 98007-3827
Bellevue, WA 98007-3827
Phone 800-682-6934
Authorized official
Cosette Dawna Rae
Ceo
8006826934
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