| NPI | 1467147934 |
|---|---|
| Doing Business As | REVIVAL HOMECARE AGENCY - HOME HEALTH |
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Provider Enrollment Manager 502-420-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2024-09-18 |