Provider Demographics
NPI:1235953548
Name:REVIVE HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:REVIVE HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MAYANKKUMAR
Authorized Official - Middle Name:BALADEVBHAI
Authorized Official - Last Name:PATELOWNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-903-2312
Mailing Address - Street 1:9015 TOWN CENTER PKWY UNIT 135
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5308
Mailing Address - Country:US
Mailing Address - Phone:845-903-2312
Mailing Address - Fax:
Practice Address - Street 1:9015 TOWN CENTER PKWY UNIT 135
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5308
Practice Address - Country:US
Practice Address - Phone:845-903-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health