Provider Demographics
NPI:1194013128
Name:RESTORATIVE CARE
Entity Type:Organization
Organization Name:RESTORATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN/DDIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-315-2820
Mailing Address - Street 1:3038 EDMONTON PL
Mailing Address - Street 2:CHARLOTTE
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0130
Mailing Address - Country:US
Mailing Address - Phone:704-315-2820
Mailing Address - Fax:
Practice Address - Street 1:3038 EDMONTON PL
Practice Address - Street 2:CHARLOTTE
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0130
Practice Address - Country:US
Practice Address - Phone:704-315-2820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health