Provider Demographics
NPI:1164013199
Name:RESTORATIVE HEALTH GROUP INC
Entity Type:Organization
Organization Name:RESTORATIVE HEALTH GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RHG
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDINGS, LLC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-808-2480
Mailing Address - Street 1:PO BOX 7324
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-0324
Mailing Address - Country:US
Mailing Address - Phone:715-808-2480
Mailing Address - Fax:
Practice Address - Street 1:1091 SUTHERLAND AVE
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-7509
Practice Address - Country:US
Practice Address - Phone:715-808-2480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Group - Multi-Specialty