RESTORE INCORPORTED NPI 1497424949

NPI Information

NPI: 1497424949
Provider Name: RESTORE INCORPORTED

Doing Business As: REFINE DETOXIFICATION AND RECOVERY CENTER

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
211 CUSHMAN ST
FAIRBANKS, AK
ZIP 99701
Phone: (907) 374-1097
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RESTORE INCORPORTED is a rehabilitation and substance use disorder clinic center in Fairbanks, AK. RESTORE INCORPORTED NPI is 1497424949. The provider is registered as an organization entity type.
The provider Is Doing Business As Refine Detoxification And Recovery Center.

The provider's business location address is:

211 CUSHMAN ST
FAIRBANKS, AK
ZIP 99701-639
Phone: (907) 374-1097

The provider's authorized official is Shelissa F Thomas .
The authorized official title is Ceo and has the following contact phone number (907) 374-1097.

The enumeration date for this NPI number is 9/8/2021 and was last updated on 1/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility				No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1687081	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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