MEDICARE: RESTORATION HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1073268900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATION HOME CARE LLC

Provider Business Mailing Address
First Line	:	110 E BROWARD BLVD STE 1700
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-3500
Country	:	US
Telephone Number	:	954-678-4770
Fax Number	:	954-271-3196

Provider Business Practice Location Address
First Line	:	110 E BROWARD BLVD STE 1700
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-3500
Country	:	US
Telephone Number	:	954-678-4770
Fax Number	:	954-271-3196

Authorized Official
Title or Position	:	OWNER / ADMINISTRATOR
Name	:	ISAAC HOZA
Credential	:
Telephone Number	:	954-678-4770

Provider Enumeration Date	:	02/18/2022
Last Update Date	:	02/18/2022

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