Provider Demographics
NPI:1508382557
Name:RESTORER HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:RESTORER HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-343-8505
Mailing Address - Street 1:10065 SANDMEYER LN STE 301
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-3528
Mailing Address - Country:US
Mailing Address - Phone:267-343-8505
Mailing Address - Fax:267-343-7976
Practice Address - Street 1:10065 SANDMEYER LN STE 301
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3528
Practice Address - Country:US
Practice Address - Phone:267-343-8505
Practice Address - Fax:267-343-7976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care