Provider Demographics
NPI:1518363431
Name:RESTORATION HEALTH CARE INC
Entity type:Organization
Organization Name:RESTORATION HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUOGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-538-8254
Mailing Address - Street 1:484 LOWELL ST
Mailing Address - Street 2:SUITE 2B-1
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7934
Mailing Address - Country:US
Mailing Address - Phone:978-587-2040
Mailing Address - Fax:978-587-3182
Practice Address - Street 1:484 LOWELL ST
Practice Address - Street 2:SUITE 2B-1
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7934
Practice Address - Country:US
Practice Address - Phone:978-587-2040
Practice Address - Fax:978-587-3182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health