MEDICARE: RESTORATIVE HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1659185411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATIVE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	14525 VALLEY VIEW AVE STE F
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-5237
Country	:	US
Telephone Number	:	714-420-5268
Fax Number	:

Provider Business Practice Location Address
First Line	:	14525 VALLEY VIEW AVE STE F
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-5237
Country	:	US
Telephone Number	:	714-420-5268
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA WONG
Credential	:	NURSE PRACTITIONER
Telephone Number	:	714-420-5268

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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Directions to “RESTORATIVE HOME HEALTH LLC ” Practice Location

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