Provider Demographics
NPI:1194412759
Name:RESTPOINT PROGRAM SERVICES, LLC
Entity type:Organization
Organization Name:RESTPOINT PROGRAM SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDMONDSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:513-432-8045
Mailing Address - Street 1:976 N DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-1927
Mailing Address - Country:US
Mailing Address - Phone:513-432-8045
Mailing Address - Fax:
Practice Address - Street 1:976 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-1927
Practice Address - Country:US
Practice Address - Phone:513-432-8045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care