Provider Demographics
NPI:1447094222
Name:RESTORATION AND RECREATION LLC
Entity type:Organization
Organization Name:RESTORATION AND RECREATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TORY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:CTRS
Authorized Official - Phone:804-690-9781
Mailing Address - Street 1:10305 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1118
Mailing Address - Country:US
Mailing Address - Phone:804-690-0935
Mailing Address - Fax:
Practice Address - Street 1:10305 HOPKINS RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1118
Practice Address - Country:US
Practice Address - Phone:804-690-0935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Multi-Specialty