Healthcare Provider Details

I. General information

NPI: 1447094222
Provider Name (Legal Business Name): RESTORATION AND RECREATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10305 HOPKINS RD
CHESTER VA
23831-1118
US

IV. Provider business mailing address

10305 HOPKINS RD
CHESTER VA
23831-1118
US

V. Phone/Fax

Practice location:
  • Phone: 804-690-0935
  • Fax:
Mailing address:
  • Phone: 804-690-0935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name: TORY L ROGERS
Title or Position: OWNER/CEO
Credential: CTRS
Phone: 804-690-9781