Organization
RESTORE LLC
Active
Other names
R.E.A.C.H.
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY M THOMAS (CHIEF OPERATIONS OFFICER)
(907) 374-1097
Entity
Organization
Contact information
Practice address
513 12TH AVE, FAIRBANKS, AK 99701-4910
(907) 374-1097
Mailing address
PO BOX 73004, FAIRBANKS, AK 99707-3004
(907) 374-1097
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750321
—
AK
Enumeration date
10/27/2022
Last updated
07/07/2025
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