Provider Demographics
NPI:1225776255
Name:RESTORATIVE HEALTH GROUP INC
Entity Type:Organization
Organization Name:RESTORATIVE HEALTH GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRAMONTES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:715-808-2480
Mailing Address - Street 1:743 GOLD HILL PL S # 38
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-1101
Mailing Address - Country:US
Mailing Address - Phone:715-808-2480
Mailing Address - Fax:
Practice Address - Street 1:743 GOLD HILL PL S # 38
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-1101
Practice Address - Country:US
Practice Address - Phone:715-808-2480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTORATIVE HEALTH GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)