Provider Demographics
NPI:1932471885
Name:RESTORATIVE HOMECARE SERVICES
Entity Type:Organization
Organization Name:RESTORATIVE HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING/ CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-450-1640
Mailing Address - Street 1:2002 E 62ND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2310
Mailing Address - Country:US
Mailing Address - Phone:317-450-1640
Mailing Address - Fax:317-253-0090
Practice Address - Street 1:2002 E 62ND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2310
Practice Address - Country:US
Practice Address - Phone:317-450-1640
Practice Address - Fax:317-253-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health