Provider Demographics
NPI:1790745511
Name:HELPING RESTORE ABILITY
Entity Type:Organization
Organization Name:HELPING RESTORE ABILITY
Other - Org Name:HELPING RESTORE ABILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NIEDERMAYER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:817-469-1977
Mailing Address - Street 1:4300 BELTWAY PLACE, SUITE 130
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018
Mailing Address - Country:US
Mailing Address - Phone:817-469-1977
Mailing Address - Fax:817-461-2334
Practice Address - Street 1:4300 BELTWAY PLACE, SUITE 130
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018
Practice Address - Country:US
Practice Address - Phone:817-469-1977
Practice Address - Fax:817-461-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008525251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162710101Medicaid
TX679407Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER