NPI | 1912692484 |
---|---|
Doing Business As | REVIVAL HOMECARE AGENCY - BALTIMORE |
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 |