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NPI Code Detail

MEDICARE: RESTORE HEALTH AND WELLNESS CENTER

MEDICARE: RESTORE HEALTH AND WELLNESS CENTER
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
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1790568053
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESTORE HEALTH AND WELLNESS CENTER
Provider Business Mailing Address
First Line : 6918 OWENSMOUTH AVE
Second Line :
City : CANOGA PARK
State : CA
Zip : 91303-2003
Country : US
Telephone Number : 189-462-7728
Fax Number :
Provider Business Practice Location Address
First Line : 4315 COOLIDGE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-5905
Country : US
Telephone Number : 818-946-2772
Fax Number :
Authorized Official
Title or Position : COO
Name : ERIC J LEON
Credential :
Telephone Number : 954-641-5366
Provider Enumeration Date : 08/18/2023
Last Update Date : 08/24/2023

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Directions to “RESTORE HEALTH AND WELLNESS CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.