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General NPI Number Information
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NPI Number | 1548619935
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Entity Type | Organization
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Legal Business Name | RESTORATION HEALTH SERVICES LLC
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 6399 LITTLE RIVER TPKE STE 201
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City | ALEXANDRIA
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State | VA
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Zip | 22312-5093
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Country | US
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Telephone | 703-910-2668
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Fax |
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Provider Business Mailing Address
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Address Line | 6399 LITTLE RIVER TPKE STE 201
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City | ALEXANDRIA
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State | VA
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Zip | 22312-5093
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Country | US
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Telephone | 703-910-2668
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARY H SESAY
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Credential |
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Telephone | 703-910-2668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO-161211
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License Number State | VA
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