Provider Demographics
NPI:1780398123
Name:RESTORATIVE CARE SERVICES LLC
Entity type:Organization
Organization Name:RESTORATIVE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXAMED
Authorized Official - Suffix:
Authorized Official - Credentials:LGSW
Authorized Official - Phone:612-227-7918
Mailing Address - Street 1:1500 MCANDREWS RD W STE 221A
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4445
Mailing Address - Country:US
Mailing Address - Phone:612-227-7918
Mailing Address - Fax:612-488-4222
Practice Address - Street 1:1500 MCANDREWS RD W STE 221A
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4445
Practice Address - Country:US
Practice Address - Phone:612-227-7918
Practice Address - Fax:612-488-4222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center