Provider Demographics
NPI:1487722112
Name:RESTART, INC
Entity type:Organization
Organization Name:RESTART, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:JASPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-588-7633
Mailing Address - Street 1:4000 OLSON MEMORIAL HWY
Mailing Address - Street 2:SUITE 610
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-5351
Mailing Address - Country:US
Mailing Address - Phone:763-588-7633
Mailing Address - Fax:763-588-7613
Practice Address - Street 1:4000 OLSON MEMORIAL HWY
Practice Address - Street 2:SUITE 610
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-5351
Practice Address - Country:US
Practice Address - Phone:763-588-7633
Practice Address - Fax:763-588-7613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home