Provider Demographics
NPI:1922240175
Name:RESTORATION HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:RESTORATION HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-905-5980
Mailing Address - Street 1:2260 WARRENSVILLE CENTER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3146
Mailing Address - Country:US
Mailing Address - Phone:216-905-5980
Mailing Address - Fax:216-658-2088
Practice Address - Street 1:2260 WARRENSVILLE CENTER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44118-3146
Practice Address - Country:US
Practice Address - Phone:216-905-5980
Practice Address - Fax:216-658-2088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTORATION HOMECARE AGENCY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health