Restore LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

RESTORE LLC

Practice address

1088 Tazlina CT
Fairbanks, AK 99701-1421

Phone

(907) 374-1097

Fax

(907) 374-1062

NPI assigned

Dec 11, 2020

Last updated

Oct 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy M ThomasNPI 1912562646

Title

Chief Operations Officer

Phone

(907) 374-1097

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Restore LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fairbanks, AK
  • NPI 1134588528
  NPD tax ID
• Restore LLC

  dba Insite Toxicology and Laboratory Services

  • Clinical Medical Laboratory
  • Fairbanks, AK
  • NPI 1174297402
  NPD tax ID
• Restore LLC

  • Substance Abuse Rehabilitation Facility
  • Fairbanks, AK
  • NPI 1295329803
  NPD tax ID
• Restore LLC

  dba Refine Detoxification and Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fairbanks, AK
  • NPI 1497424949
  NPD tax ID
• Restore LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Fairbanks, AK
  • NPI 1609593821
  NPD tax ID
• Restore LLC

  • Substance Abuse Rehabilitation Facility
  • Fairbanks, AK
  • NPI 1881210474
  NPD tax ID

Practitioners 1

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.

• Timothy Thomas

  • Addiction (Substance Use Disorder) Counselor
  • Fairbanks, AK
  • NPI 1912562646
  Authorized official Same address or phone

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1790381929",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 TAZLINA CT",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997011421",
            "telephone_number": "907-374-1097",
            "fax_number": "907-374-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "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": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712403",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Restore LLC
• Restore LLC (Insite Toxicology and Laboratory Services)
• Restore LLC
• Restore LLC (Refine Detoxification and Recovery Center)
• Restore LLC
• Restore LLC
• Restore Physical Therapy LLC
• Eugenia Reuter
• Jessica Revells, COTA/L
• Revive Medical Spa LLC

• Substance Abuse Rehabilitation Facility in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Substance Abuse Rehabilitation Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.