MEDICARE: RESTORATIVE CARE HEALTH CENTER L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407088099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATIVE CARE HEALTH CENTER L.L.C.

Provider Business Mailing Address
First Line	:	3361 GEN DE GAULLE DR
Second Line	:	SUITE B
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6701
Country	:	US
Telephone Number	:	504-367-5303
Fax Number	:

Provider Business Practice Location Address
First Line	:	3361 GEN DE GAULLE DR
Second Line	:	SUITE B
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6701
Country	:	US
Telephone Number	:	504-367-5303
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KENNETH WILLIAMS
Credential	:	M.D.
Telephone Number	:	50435675303

Provider Enumeration Date	:	08/14/2009
Last Update Date	:	08/14/2009

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