Provider Demographics
NPI:1164743456
Name:RESTORATIVE NURSING SERVICES
Entity type:Organization
Organization Name:RESTORATIVE NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, M ED
Authorized Official - Phone:910-583-0264
Mailing Address - Street 1:111 LAMON ST STE 124
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-4956
Mailing Address - Country:US
Mailing Address - Phone:910-672-7043
Mailing Address - Fax:800-403-8236
Practice Address - Street 1:111 LAMON ST STE 124
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4956
Practice Address - Country:US
Practice Address - Phone:910-672-7043
Practice Address - Fax:800-403-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4111253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care