MEDICARE: RESTORATION HOME HEALTHCARE 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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1467393827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATION HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	4120 ANSAR LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-3123
Country	:	US
Telephone Number	:	463-206-7760
Fax Number	:

Provider Business Practice Location Address
First Line	:	1134 N MOUNT ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-3151
Country	:	US
Telephone Number	:	463-206-7760
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICAH BRONER
Credential	:	RN
Telephone Number	:	463-206-7760

Provider Enumeration Date	:	04/01/2026
Last Update Date	:	04/01/2026

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