Provider Demographics
NPI:1346247095
Name:RESTA HOME HEALTH, LLC
Entity Type:Organization
Organization Name:RESTA HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONATESTA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:814-948-2848
Mailing Address - Street 1:3901 BIGLER AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHERN CAMBRIA
Mailing Address - State:PA
Mailing Address - Zip Code:15714-2050
Mailing Address - Country:US
Mailing Address - Phone:814-948-2848
Mailing Address - Fax:814-948-2849
Practice Address - Street 1:3901 BIGLER AVE
Practice Address - Street 2:
Practice Address - City:NORTHERN CAMBRIA
Practice Address - State:PA
Practice Address - Zip Code:15714-2050
Practice Address - Country:US
Practice Address - Phone:814-948-2848
Practice Address - Fax:814-948-2849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA80230501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA398023Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER