National Provider Identifier Database

RESTORE LLC
Substance Abuse Treatment, Children

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.


Contact Information

RESTORE LLC
513 12TH AVE
FAIRBANKS, AK99701-4910
Phone: 907-374-1097
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Treatment, Children 3245S0500X

* Indicates primary specialty

NPI Profile & details for RESTORE LLC

NPI Number 1609593821
Legal business name
LBN
RESTORE LLC
Authorized official TIMOTHY THOMAS - (CHIEF OPERATIONS OFFICER)
Entity Organization
Organization subpart No
Enumeration date 10/27/2022
Last updated 07/07/2025 - About 11 months ago
Sole proprietor1 Not specified
Identifiers
  • AK Medicaid: 1750321

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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