Active NPI
Restore Health Services Inc
- In Home Supportive Care Agency
- Mount Dora, FL
National Provider Identifier
1245761253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 233357
- Legal business name
- RESTORE HEALTH SERVICES INC
- Practice address
- 4400 N Highway 19a Ste 9
Mount Dora, FL 32757-2022 - Phone
- (352) 589-0357
- Fax
- (888) 979-6004
- NPI assigned
- Mar 22, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Merritt
- Title
- President
- Phone
- (352) 589-0357
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 233357 | FL | Primary |
Addresses
Primary practice location
4400 N Highway 19a Ste 9
Mount Dora, FL 32757-2022
Mailing address
4400 N Highway 19a Ste 9
Mount Dora, FL 32757-2022
Phone (352) 589-0357
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 012257100 | Medicaid | FL |
Other names 2
- Restore Care Services
- Restore Home Health Agency
National Provider Directory
National Provider Directory- Tax ID family
- Restore Care Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- In Home Supportive Care Agency
- Tavares, FL
- NPI 1447682943
Locations
4400 N Highway 19A
Ste 9
Mount Dora, FL 32757
Phone (352) 434-9185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490140800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1592179200000",
"number": "1245761253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 N HIGHWAY 19A STE 9",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327572022",
"telephone_number": "352-589-0357",
"fax_number": "888-979-6004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 N HIGHWAY 19A STE 9",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327572022",
"telephone_number": "352-589-0357",
"fax_number": "888-979-6004"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RESTORE HEALTH SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-22",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A",
"authorized_official_last_name": "MERRITT",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "352-589-0357"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "FL",
"license": "233357",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "012257100",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Restore Care Services",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Restore Care Services",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Restore Home Health Agency",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mount Dora, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.