# RESTORATION HEALTH CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184109803
- **Authorized official:** JESSICA MANZANO (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (316) 312-7780

## Contact information

- **Practice address:** 1541 N LINDBERG CIR, WICHITA, KS 67206-6400
- **Practice address phone:** (316) 258-5882
- **Mailing address:** 12300 E FOUR OAKS ST, WICHITA, KS 67226-8366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2018
- **Last updated:** 02/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201281390A | — | KS |