Healthcare Provider Details

I. General information

NPI: 1093646614
Provider Name (Legal Business Name): RESTWELL HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11295 ATTALA RD 4102
SALLIS MS
39160
US

IV. Provider business mailing address

11295 ATTALA RD 4102
SALLIS MS
39160
US

V. Phone/Fax

Practice location:
  • Phone: 662-582-4686
  • Fax:
Mailing address:
  • Phone: 662-582-4686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MONICA RILEY
Title or Position: LPN/OWNER
Credential:
Phone: 662-582-4686