Provider Demographics
NPI:1073508909
Name:RESTORATIVE HEALTH SYSTEMS,INC.
Entity Type:Organization
Organization Name:RESTORATIVE HEALTH SYSTEMS,INC.
Other - Org Name:CENTER FOR HEALTH ENHANCEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:WILBERT
Authorized Official - Last Name:SCHIFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT, AT,C
Authorized Official - Phone:440-998-0033
Mailing Address - Street 1:2241 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-3437
Mailing Address - Country:US
Mailing Address - Phone:440-998-0033
Mailing Address - Fax:440-998-0091
Practice Address - Street 1:2241 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-3437
Practice Address - Country:US
Practice Address - Phone:440-998-0033
Practice Address - Fax:440-998-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOHIO 4118261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2172456Medicaid
OH2172456Medicaid