RESTORE FUNCTIONAL RESTORATION, LLC


Address: 20002 N 19th Ave # B100, Phoenix, AZ 85027-4250
Phone: 6027141408

RESTORE FUNCTIONAL RESTORATION, LLC (NPI# 1952716698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952716698
Entity Type Organization
Organization Name RESTORE FUNCTIONAL RESTORATION, LLC
Practice Address 20002 N 19th Ave # B100
Phoenix
AZ 85027-4250
Practice Telephone 6027141408
Practice Fax Number 8884687614
Mailing Telephone 6027141408
Mailing Fax Number 8884687614
Enumeration Date 2014-06-20
Last Update Date 2014-06-20
Authorized Official Name AMY RICHTER BODE (OWNER/COO)
Authorized Official Telephone 6024039711
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0400X Clinic/Center
Specialization: Rehabilitation
Ambulatory Health Care Facilities

Office Location

Street Address 20002 N 19TH AVE # B100
City PHOENIX
State AZ
Zip Code 85027-4250

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Taxonomy Information

Taxonomy Code 261QR0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation

Taxonomy Definition

Definition to come...

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1629485198 Duane Young Clinic/Center 650 E Indian School Rd, Phoenix, AZ 85012-1839 2014-07-16
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1881737849 Compass Mental Health, LLC Clinic/Center 4550 E Bell Rd, Suite 147, Phoenix, AZ 85032-9306 2007-02-15
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Competitor

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City PHOENIX
Zip Code 85027

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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