Provider Demographics
NPI:1023876547
Name:HANDS THAT RESTORE LLC
Entity type:Organization
Organization Name:HANDS THAT RESTORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAHOGANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-388-6088
Mailing Address - Street 1:6808 UNIVERSITY AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2779
Mailing Address - Country:US
Mailing Address - Phone:414-678-9003
Mailing Address - Fax:
Practice Address - Street 1:6808 UNIVERSITY AVE STE 108
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2779
Practice Address - Country:US
Practice Address - Phone:414-678-9003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care