Provider Demographics
NPI:1902830995
Name:RESTORATIVE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:RESTORATIVE HOME HEALTH CARE, LLC
Other - Org Name:ELARA CARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF REGULATORY
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-234-1866
Mailing Address - Street 1:14295 MIDWAY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3678
Mailing Address - Country:US
Mailing Address - Phone:903-537-8656
Mailing Address - Fax:903-537-8470
Practice Address - Street 1:300 WASHINGTON ST STE 402B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-450-6131
Practice Address - Fax:318-450-6134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203781098251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1403539Medicaid
LA19-7472Medicare ID - Type Unspecified