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General NPI Number Information
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NPI Number | 1518750454
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Entity Type | Organization
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Legal Business Name | REVIVE HOME CARE LLC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 175 CAPITAL BLVD STE 402
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City | ROCKY HILL
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State | CT
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Zip | 06067-3914
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Country | US
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Telephone | 860-743-9040
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Fax |
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Provider Business Mailing Address
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Address Line | 64 HARBISON AVE
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City | HARTFORD
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State | CT
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Zip | 06106-3011
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Country | US
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Telephone | 860-743-9040
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YULEYCI WOODS
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Credential |
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Telephone | 860-743-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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