REVIVAL HOME CARE (NPI# 1336498906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336498906 |
| Entity Type | Organization |
| Organization Name | REVIVAL HOME CARE |
| Practice Address |
8269 W State Ave Glendale AZ 85303 |
| Practice Telephone | 6023344187 |
| Practice Fax Number | 6023344187 |
| Mailing Telephone | 6023344187 |
| Mailing Fax Number | 6023344187 |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |
| Authorized Official Name | MRS. FIDELITE KANKINDI (CAREGIVER) |
| Authorized Official Telephone | 6232971305 |
| Authorized Official Credential | MBR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
AL8758H | AZ | Nursing & Custodial Care Facilities |
| Street Address |
8269 W STATE AVE |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962050138 | Karina Navarrete | Specialist/Technologist | 7418 W. Fleetwood Ln, Glendale, AZ 85303 | 2019-08-29 |
| 1043733280 | Ainsley P. Vergara | Speech-Language Pathologist | 7355 W Orangewood Ave, Glendale, AZ 85303 | 2017-07-19 |
| 1043688492 | Karina Sosa | Specialist/Technologist | 7829 W San Miguel Avenue, Glendale, AZ 85303 | 2015-09-02 |
| 1437546462 | Westwind Dental Glendale, Pllc | Dentist | 6740 W Camelback Road, Glendale, AZ 85303 | 2015-04-16 |
| 1700153707 | Habiitation and Independant Living Inc | Nursing Care | 7304 N 82nd Ave, Glendale, AZ 85303 | 2011-11-19 |
| 1225160658 | Kristy Beth Malecki | Speech-Language Pathologist | 7355 W Orangewood, Desert Spirit School, Glendale, AZ 85303 | 2007-03-12 |
| 1104980325 | Sharon Yvonne Thompson | Technician | 7384 W Colter St, Glendale, AZ 85303 | 2006-12-21 |
| 1447772264 | Bob Kabamba | Behavior Technician | 7136 N 73rd Dr, Gendale, AZ 85303 | 2017-07-13 |
| 1427420504 | Quick Med Center LLC | Family Medicine | 5104 N 67th Ave, Glendale, AZ 85303 | 2015-10-28 |
| 1932581766 | 6730 W Camelback Road LLC Dba Instantmed Health Center | Clinic/Center | 5104 N 67th Ave, Glendale, AZ 85303 | 2015-06-29 |
| Find all providers in zip 85303 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649736026 | Lakeview Assisted Living LLC | Assisted Living Facility | 20044 N 68th Dr, Glendale, AZ 85308-5594 | 2019-02-11 |
| 1720579022 | Millennium Residential Home Inc. | Assisted Living Facility | 10325 W San Juan Ave, Glendale, AZ 85307-4310 | 2018-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511999 | Fanaka Enterprises LLC | Assisted Living Facility | 3925 E 1st St, Tucson, AZ 85711-1001 | 2020-09-07 |
| 1114536752 | The Heritage Behavioral Health Home LLC | Assisted Living Facility | 3927 W Rovey Ave, Phoenix, AZ 85019-1633 | 2020-07-29 |
| 1801420476 | Holy Trinity Behavioral,llc | Assisted Living Facility | 1630 W Nancy Ln, Phoenix, AZ 85041-5540 | 2020-02-23 |
| 1184258758 | Holy Trinity Behavioral,llc | Assisted Living Facility | 5308 W Vernon Ave, Phoenix, AZ 85035-1953 | 2020-02-23 |
| 1487287108 | Christine M Kemboi | Assisted Living Facility | 8435 W Hughes Dr, Tolleson, AZ 85353-3902 | 2020-02-20 |
| 1154967826 | Home of Empathy LLC | Assisted Living Facility | 8102 E 6th St, Tucson, AZ 85710-2416 | 2019-11-18 |
| 1083261945 | D&g Behavioral Health LLC | Assisted Living Facility | 3119 N 46th Dr, Phoenix, AZ 85031-3705 | 2019-08-24 |
| 1881249902 | A Tender Hand Assisted Living Home, LLC, Dba | Assisted Living Facility | 6216 S 36th St, Phoenix, AZ 85042-4904 | 2019-08-06 |
| 1265098339 | Affinity of Hope Care Home | Assisted Living Facility | 7518 S 15th Dr, Phoenix, AZ 85041-6935 | 2019-05-14 |
| 1912561176 | Hope Behavioral Health Residential Care | Assisted Living Facility | 17547 W Desert Bloom St, Goodyear, AZ 85338-4713 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.