=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649987587
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RESTORATIVE CARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2022
-----------------------------------------------------
Last Update Date | 05/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 438 GANTTOWN RD
-----------------------------------------------------
City | SEWELL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08080-2341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 862-940-9565
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 BAYARD DR
-----------------------------------------------------
City | WILLIAMSTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08094-8844
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-629-4488
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | LEO ONYEKWERE ONUOHA
-----------------------------------------------------
Credential | MSN, RN
-----------------------------------------------------
Telephone | 512-774-3294
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------