Provider Demographics
NPI:1144096538
Name:RESTORE LIFE HOME HEALTH PRACTICE, LLC
Entity type:Organization
Organization Name:RESTORE LIFE HOME HEALTH PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ODI
Authorized Official - Last Name:ASIEDU-SARPONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-804-9022
Mailing Address - Street 1:2246 S HAMILTON RD STE 203B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-4317
Mailing Address - Country:US
Mailing Address - Phone:614-804-9022
Mailing Address - Fax:
Practice Address - Street 1:2246 S HAMILTON RD STE 203B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-4317
Practice Address - Country:US
Practice Address - Phone:614-804-9022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health