# RESTORATION HEALTH CARE OF COMMERCE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northridge Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912079039
- **Authorized official:** MR. JERRY WISE (DIRECTOR)
- **Authorized official phone:** (706) 335-1101

## Contact information

- **Practice address:** 70 MEDICAL CENTER DRIVE, COMMERCE, GA 30529
- **Practice address phone:** (706) 335-1000
- **Practice address fax:** (706) 335-7701
- **Mailing address:** 70 MEDICAL CENTER DRIVE, COMMERCE, GA 30529
- **Mailing address phone:** (706) 335-1120
- **Mailing address fax:** (706) 335-6033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 273R00000X | Psychiatric Hospital Unit | — | NULL | — |
| 275N00000X | Medicare Defined Swing Bed Hospital Unit | — | NULL | — |
| 282NR1301X | Rural Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 08/12/2020