Organization Active NPI

Restoration House LLC

  • Community/Behavioral Health Agency
  • Louisville, KY
National Provider Identifier
1336836691
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
RESTORATION HOUSE LLC
Practice address
2600 W Broadway Ste 209
Louisville, KY 40211-1370
Phone
(502) 907-7541
NPI assigned
Apr 18, 2023
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeremy JonesNPI 1659084994
Title
Owner
Phone
(502) 907-7541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2600 W Broadway Ste 209
Louisville, KY 40211-1370

Mailing address

2600 W Broadway Ste 209
Louisville, KY 40211-1370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250508000361 KY Part B Supplier - Clinic/Group Practice 9931626405 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

2600 W Broadway
Ste 209
Louisville, KY 40211
Phone (502) 493-7794

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1336836691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 W BROADWAY STE 209",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 W BROADWAY STE 209",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111370",
            "telephone_number": "502-907-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-18",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-907-7541"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.