Provider Demographics
NPI:1588470249
Name:RESTORE CARE HOME CARE, LLC
Entity type:Organization
Organization Name:RESTORE CARE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-418-8124
Mailing Address - Street 1:2333 ROSTOCK CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-2397
Mailing Address - Country:US
Mailing Address - Phone:317-418-8124
Mailing Address - Fax:
Practice Address - Street 1:2333 ROSTOCK CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-2397
Practice Address - Country:US
Practice Address - Phone:317-418-8124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No332U00000XSuppliersHome Delivered Meals