Refine Detoxification And Recovery Center

LBN: Restore Incorported
Refine Detoxification And Recovery Center is an health care organization with primary practice located at 211 Cushman St , Fairbanks AK 99701-4639. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder is the primary health care specialty. Restore Incorported can be contacted via phone (907) 374-1097, or through Thomas, Shelissa F via phone (907) 374-1097.

Contact Information

Primary practice address
211 Cushman St Fairbanks AK 99701-4639
Phone: (907) 374-1097
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Thomas, Shelissa F
Phone: (907) 374-1097

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1497424949
LBN Legal business name Restore Incorported
DBA Doing business as Refine Detoxification And Recovery Center
Authorized official Thomas, Shelissa F
Entity Organization
Organization subpart 1 No
Enumeration date Sep 8th, 2021
Last updated Jan 10th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497424949 NPPES
Alaska MEDICAID 1687081

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