Provider Demographics
NPI:1376009258
Name:REST, LLC
Entity Type:Organization
Organization Name:REST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-806-3502
Mailing Address - Street 1:2205 POKEBERRY PARK
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8641
Mailing Address - Country:US
Mailing Address - Phone:859-806-3502
Mailing Address - Fax:
Practice Address - Street 1:1604 LOUISVILLE RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-3919
Practice Address - Country:US
Practice Address - Phone:859-806-3502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility