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General NPI Number Information
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NPI Number | 1679012314
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Entity Type | Organization
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Legal Business Name | RESTORATION HOME CARE INC.
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Dates
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Enumeration Date | 02/14/2017
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Last Update Date | 12/26/2017
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Provider Practice Location Address
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Address Line | 552 E 44TH ST
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City | CHICAGO
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State | IL
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Zip | 60653-3466
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Country | US
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Telephone | 312-735-5811
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Fax |
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Provider Business Mailing Address
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Address Line | 552 E 44TH ST
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City | CHICAGO
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State | IL
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Zip | 60653-3466
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Country | US
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Telephone | 312-735-5811
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW AWAKAN
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Credential |
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Telephone | 312-735-5811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 3001336
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License Number State | IL
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