Revival Home

LBN: Revival Home
Revival Home is an health care organization with primary practice located at 68 W 7Th St , Hialeah FL 33010-4308. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Revival Home can be contacted via phone (305) 887-0808, or through Benito, Jorge via phone (305) 887-0808.

Contact Information

Primary practice address
68 W 7Th St Hialeah FL 33010-4308
Phone: (305) 887-0808
Fax: (305) 887-3996
Website:
Map and Directions
Authorized official contact:
Name: Benito, Jorge Doctor of Medicine (MD)
Phone: (305) 887-0808

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X AL9109 Florida

Profile Details

NPI number 1700051489
LBN Legal business name Revival Home
DBA Doing business as
Authorized official Benito, Jorge Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 24th, 2008
Last updated Apr 24th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700051489 NPPES
Florida MEDICAID 140707100

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