| NPI | 1730919812 |
|---|---|
| Doing Business As | REVIVAL HOMECARE AGENCY - MARYLAND |
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Mgr Provider Enrollment 502-394-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-09-18 |