Provider Demographics
NPI:1013501972
Name:RESTORERS HEALTH SERVICES LLC.
Entity Type:Organization
Organization Name:RESTORERS HEALTH SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ADEBIYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-949-2717
Mailing Address - Street 1:7664 WOODLAWN DR APT 3
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-4068
Mailing Address - Country:US
Mailing Address - Phone:678-949-2717
Mailing Address - Fax:
Practice Address - Street 1:7664 WOODLAWN DR APT 3
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55112-4068
Practice Address - Country:US
Practice Address - Phone:678-949-2717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN322COtherTHIS NUMBER IS ONLY ASSOCIATED WITH THE BUSINESS