Provider Demographics
NPI:1215757836
Name:RESTORATION AND RECOVERY, LLC
Entity type:Organization
Organization Name:RESTORATION AND RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERS
Authorized Official - Prefix:
Authorized Official - First Name:MARIVELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-302-4288
Mailing Address - Street 1:7495 W AZURE DR STE 246
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4436
Mailing Address - Country:US
Mailing Address - Phone:702-302-4288
Mailing Address - Fax:
Practice Address - Street 1:7495 W AZURE DR STE 246
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4436
Practice Address - Country:US
Practice Address - Phone:702-302-4288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility