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RESTORE INCORPORATED NPI 1881210474


NPI Information

NPI: 1881210474
Provider Name: RESTORE INCORPORATED
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
1095 TENA AVE
FAIRBANKS, AK
ZIP 99701
Phone: (907) 374-1097
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RESTORE INCORPORATED is a substance abuse rehabilitation facility in Fairbanks, AK. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. RESTORE INCORPORATED NPI is 1881210474. The provider is registered as an organization entity type.

The provider's business location address is:

1095 TENA AVE
FAIRBANKS, AK
ZIP 99701-422
Phone: (907) 374-1097
Fax: (907) 374-1062

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

The enumeration date for this NPI number is 6/19/2020 and was last updated on 8/24/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation FacilityYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11709994MEDICAIDALASKA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.