Provider Demographics
NPI:1376429928
Name:RESTORATION HEALTH
Entity type:Organization
Organization Name:RESTORATION HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:REINERS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP FNP-C
Authorized Official - Phone:350-930-4174
Mailing Address - Street 1:101 HIGHWAY 95
Mailing Address - Street 2:
Mailing Address - City:WEISER
Mailing Address - State:ID
Mailing Address - Zip Code:83672-5709
Mailing Address - Country:US
Mailing Address - Phone:360-930-4174
Mailing Address - Fax:
Practice Address - Street 1:101 HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:WEISER
Practice Address - State:ID
Practice Address - Zip Code:83672-5709
Practice Address - Country:US
Practice Address - Phone:360-930-4174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine