Healthcare Provider Details

I. General information

NPI: 1346247095
Provider Name (Legal Business Name): RESTA HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BIGLER AVE
NORTHERN CAMBRIA PA
15714-2050
US

IV. Provider business mailing address

3901 BIGLER AVE
NORTHERN CAMBRIA PA
15714-2050
US

V. Phone/Fax

Practice location:
  • Phone: 814-948-2848
  • Fax: 814-948-2849
Mailing address:
  • Phone: 814-948-2848
  • Fax: 814-948-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number80230501
License Number StatePA

VIII. Authorized Official

Name: THERESA BONATESTA
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 814-948-2848