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General NPI Number Information
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NPI Number | 1669053344
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Entity Type | Organization
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Legal Business Name | REVIVE CARE SOLUTIONS LLC
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 8629 STONE HILL LN
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City | LAUREL
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State | MD
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Zip | 20724-2495
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Country | US
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Telephone | 240-581-0751
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Fax |
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Provider Business Mailing Address
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Address Line | 8629 STONE HILL LN
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City | LAUREL
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State | MD
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Zip | 20724-2495
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TITUS OLUWALADE
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Credential |
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Telephone | 443-310-9779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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