Provider Demographics
NPI:1124736012
Name:REVEL CARE
Entity type:Organization
Organization Name:REVEL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-332-9306
Mailing Address - Street 1:81 POINTE CIRCLE
Mailing Address - Street 2:SUITE D #10
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615
Mailing Address - Country:US
Mailing Address - Phone:864-332-9306
Mailing Address - Fax:
Practice Address - Street 1:81 POINTE CIRCLE
Practice Address - Street 2:SUITE D #10
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615
Practice Address - Country:US
Practice Address - Phone:864-332-9306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No251J00000XAgenciesNursing Care