Provider Demographics
NPI:1265852990
Name:RESTOREME. INC.
Entity Type:Organization
Organization Name:RESTOREME. INC.
Other - Org Name:RESTORATIONS HEALTH & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATJA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:720-726-0250
Mailing Address - Street 1:6950 E BELLEVIEW AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1618
Mailing Address - Country:US
Mailing Address - Phone:720-266-6029
Mailing Address - Fax:888-846-3199
Practice Address - Street 1:6950 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1618
Practice Address - Country:US
Practice Address - Phone:720-266-6029
Practice Address - Fax:888-846-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO990129261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO990129OtherCOLORADO LICENSE
CO1538309687OtherNPI