Provider Demographics
NPI:1508922899
Name:TOTAL RESTORATION HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:TOTAL RESTORATION HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-998-4534
Mailing Address - Street 1:468 PINEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27028-6242
Mailing Address - Country:US
Mailing Address - Phone:336-998-4534
Mailing Address - Fax:336-998-4530
Practice Address - Street 1:468 PINEVILLE RD
Practice Address - Street 2:
Practice Address - City:MOCKSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27028-6242
Practice Address - Country:US
Practice Address - Phone:336-998-4534
Practice Address - Fax:336-998-4530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3540251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418422Medicaid