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General NPI Number Information
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NPI Number | 1942508221
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Entity Type | Organization
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Legal Business Name | RESTORATIVE HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 111 BUCKLIN ST
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City | LA SALLE
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State | IL
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Zip | 61301-2381
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Country | US
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Telephone | 815-780-8110
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Fax | 815-780-8185
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Provider Business Mailing Address
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Address Line | 111 BUCKLIN ST
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City | LA SALLE
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State | IL
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Zip | 61301-2381
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Country | US
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Telephone | 815-780-8110
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Fax | 815-780-8185
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANGELA MASSUTTI
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Credential | RN, BSN
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Telephone | 818-780-8110
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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 | 1011366
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License Number State | IL
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