Provider Demographics
NPI:1043385578
Name:RESTORATIVE MANAGEMENT CORP
Entity Type:Organization
Organization Name:RESTORATIVE MANAGEMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHARF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-436-5151
Mailing Address - Street 1:3839 FLATLANDS AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3533
Mailing Address - Country:US
Mailing Address - Phone:718-436-5151
Mailing Address - Fax:
Practice Address - Street 1:7 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4907
Practice Address - Country:US
Practice Address - Phone:845-342-5941
Practice Address - Fax:845-393-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY97010920324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01448517Medicaid