Restorative Haven LLC

Primary specialty

Recovery Care Clinic/CenterTaxonomy code 261QR0800X

Legal business name

RESTORATIVE HAVEN LLC

Practice address

5300 Brookdale CT
Brooklyn Park, MN 55443-3005

Phone

(612) 508-8704

NPI assigned

Jan 6, 2025

Organization subpart

No

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

Authorized official

Name

Misky Abshir

Title

Owner

Phone

(612) 508-8704

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1396554085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 PORTLAND AVE APT 904",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554153605",
            "telephone_number": "612-508-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 BROOKDALE CT",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433005",
            "telephone_number": "612-508-8704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 Portland Ave Apt 904",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554153605",
            "country_code": "US",
            "telephone_number": "612-508-8704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESTORATIVE HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "ABSHIR",
        "authorized_official_first_name": "MISKY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-508-8704"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Recovery Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.