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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
314000000X
Skilled Nursing Facility
Primary

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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