Healthcare Provider Details

I. General information

NPI: 1932055902
Provider Name (Legal Business Name): REVIVE HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37824 VAN DYKE AVE
STERLING HEIGHTS MI
48312-1840
US

IV. Provider business mailing address

37824 VAN DYKE AVE
STERLING HEIGHTS MI
48312-1840
US

V. Phone/Fax

Practice location:
  • Phone: 269-589-9659
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSHI KAUSHIK
Title or Position: DIRECTOR
Credential:
Phone: 269-589-9659