Provider Demographics
NPI:1134984362
Name:RESTORED LIFE TAXI
Entity type:Organization
Organization Name:RESTORED LIFE TAXI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-450-4928
Mailing Address - Street 1:2155 N 100 E
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IN
Mailing Address - Zip Code:46072-8490
Mailing Address - Country:US
Mailing Address - Phone:765-450-4928
Mailing Address - Fax:
Practice Address - Street 1:302 S REED RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4900
Practice Address - Country:US
Practice Address - Phone:765-450-4928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi