Provider Demographics
NPI:1275425902
Name:RESTORATION HOUSE OF LIMA, LLC
Entity type:Organization
Organization Name:RESTORATION HOUSE OF LIMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-812-0066
Mailing Address - Street 1:5100 COTNER RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-9410
Mailing Address - Country:US
Mailing Address - Phone:419-812-0066
Mailing Address - Fax:
Practice Address - Street 1:705 W SPRING ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4645
Practice Address - Country:US
Practice Address - Phone:419-773-0586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251B00000XAgenciesCase Management