Restore Therapy Llc

LBN: Restore Therapy Llc
Restore Therapy Llc is an health care organization with primary practice located at 2931 Ne Broadway , Portland OR 97232. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Restore Therapy Llc can be contacted via phone (503) 376-7114, or through Exley, Ruth via phone (503) 376-7114.

Contact Information

Primary practice address
2931 Ne Broadway Portland OR 97232
Phone: (503) 376-7114
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Exley, Ruth Licensed Clinical Social Worker (LCSW)
Phone: (503) 376-7114

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X L5795 Oregon
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X L5795 Oregon

Profile Details

NPI number 1982075636
LBN Legal business name Restore Therapy Llc
DBA Doing business as
Authorized official Exley, Ruth Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 7th, 2015
Last updated Oct 7th, 2015 - about 10 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 1982075636 NPPES
Oregon MEDICAID 500667276
Oregon MEDICAID 500691922
Oregon MEDICAID 500672043

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