Provider Demographics
NPI:1306116140
Name:REVITALIZE HOME HEALTH CARE SERVICES, LLC
Entity type:Organization
Organization Name:REVITALIZE HOME HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-362-5757
Mailing Address - Street 1:7258 ELM STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:469-362-5757
Mailing Address - Fax:469-362-5759
Practice Address - Street 1:7258 ELM ST
Practice Address - Street 2:SUITE A
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5747
Practice Address - Country:US
Practice Address - Phone:469-362-5757
Practice Address - Fax:469-362-5759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health