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Organization
RESTORATION HEALTH CARE LLC
Active
Organization
RESTORATION HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MANZANO (DIRECTOR OF REVENUE CYCLE)
(316) 312-7780
Entity
Organization
Contact information
Practice address
1541 N LINDBERG CIR, WICHITA, KS 67206-6400
(316) 258-5882
Mailing address
12300 E FOUR OAKS ST, WICHITA, KS 67226-8366
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201281390A
—
KS
Enumeration date
09/27/2018
Last updated
02/16/2021
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