NPIMap

Organization Active NPI

Restore LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Fairbanks, AK
National Provider Identifier
1609593821
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
RESTORE LLC
Practice address
513 12TH Ave
Fairbanks, AK 99701-4910
Phone
(907) 374-1097
NPI assigned
Oct 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Timothy M Thomas
Title
Chief Operations Officer
Phone
(907) 374-1097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X Primary

Addresses

Primary practice location

513 12TH Ave
Fairbanks, AK 99701-4910

Mailing address

PO Box 73004
Fairbanks, AK 99707-3004
Phone (907) 374-1097

Other identifiers 1

IdentifierTypeStateIssuer
1750321MedicaidAK

Other names 1

  • R.E.A.C.H. Other name

National Provider Directory

National Provider Directory
Tax ID family
Restore LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

526 Gaffney Rd
Fairbanks, AK 99701
Phone (907) 687-5428

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1609593821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73004",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997073004",
            "telephone_number": "907-374-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 12TH AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014910",
            "telephone_number": "907-374-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "907-374-1097"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750321",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "R.E.A.C.H.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "R.E.A.C.H.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.