Kimberly Clough

LBN: Faithfully Restored
Kimberly Clough is an health care organization with primary practice located at 1010 Tristan Ln , Longview TX 75604-1862. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Faithfully Restored can be contacted via phone (903) 918-6574, or through Clough, Kimberly via phone (903) 918-6574.

Contact Information

Primary practice address
1010 Tristan Ln Longview TX 75604-1862
Phone: (903) 918-6574
Fax: (903) 704-0980
Website:
Map and Directions
Authorized official contact:
Name: Clough, Kimberly Licensed Clinical Social Worker (LCSW)
Phone: (903) 918-6574

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 59013 Texas

Profile Details

NPI number 1003323726
LBN Legal business name Faithfully Restored
DBA Doing business as Kimberly Clough
Authorized official Clough, Kimberly Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 3rd, 2018
Last updated Jan 3rd, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1003323726 NPPES
Texas MEDICAID 373636801

Popular Providers