Restore Functional Restoration, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

RESTORE FUNCTIONAL RESTORATION, LLC

Practice address

20002 N 19TH Ave # B100
Phoenix, AZ 85027-4250

Phone

(602) 714-1408

Fax

(888) 468-7614

NPI assigned

Jun 20, 2014

Organization subpart

No

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

Authorized official

Name

Amy Richter Bode

Title

Owner/Coo

Phone

(602) 403-9711

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1952716698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20002 N 19TH AVE # B100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274250",
            "telephone_number": "602-714-1408",
            "fax_number": "888-468-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20002 N 19TH AVE # B100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274250",
            "telephone_number": "602-714-1408",
            "fax_number": "888-468-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE FUNCTIONAL RESTORATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "BODE",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "RICHTER",
        "authorized_official_title_or_position": "OWNER/COO",
        "authorized_official_telephone_number": "602-403-9711"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rest Recovery LLC
• Restassured RX
• Restor Medical & Wellness PLLC
• Restoration Therapy With Falaya Desilva LLC
• Restorative Care of Arizona, P.C.
• Restore Vitality Center
• Restoring Health Outpatient Clinic, Inc.
• Adrian G Retamoza, D.C.
• Retinal Consultants of Arizona LTD
• Laura Lynn Retson, DO

• Rehabilitation Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Rehabilitation Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.