Provider Demographics
NPI:1578202230
Name:RESTORATION HOMECARE
Entity Type:Organization
Organization Name:RESTORATION HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERRILYN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:YANCY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:513-501-8527
Mailing Address - Street 1:521 SHAWNEE RUN APT A
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-3922
Mailing Address - Country:US
Mailing Address - Phone:513-501-8527
Mailing Address - Fax:
Practice Address - Street 1:9049 SPRINGBORO PIKE STE C
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-5057
Practice Address - Country:US
Practice Address - Phone:513-501-8527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHOMECAREOtherHOMECARE