Provider Demographics
NPI:1831928084
Name:RAPHA RESTORATIVE HEALTH CARE LLC
Entity type:Organization
Organization Name:RAPHA RESTORATIVE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, DMIN
Authorized Official - Phone:804-300-1993
Mailing Address - Street 1:8177 BROOKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-3816
Mailing Address - Country:US
Mailing Address - Phone:804-300-1993
Mailing Address - Fax:
Practice Address - Street 1:8177 BROOKFIELD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-3816
Practice Address - Country:US
Practice Address - Phone:804-300-1993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-27
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No385H00000XRespite Care FacilityRespite Care