NEW REVELATION HOME CARE LLC


Address: 1500 Bragg Blvd Ste 104, Fayetteville, NC 28301-4289
Phone: 9105009043

NEW REVELATION HOME CARE LLC (NPI# 1518576289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518576289
Entity Type Organization
Organization Name NEW REVELATION HOME CARE LLC
Practice Address 1500 Bragg Blvd Ste 104
Fayetteville
NC 28301-4289
Mailing Address 4226 Raccoon Path
Fayetteville
NC 28312-9369
Practice Telephone 9105009043
Mailing Telephone 9105009043
Mailing Fax Number 9105003012
Enumeration Date 2020-07-28
Last Update Date 2020-07-28
Authorized Official Name KELLIE MICHELLE HAWKINS (ADMINISTRATOR)
Authorized Official Telephone 9105009043
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 253Z00000X In Home Supportive Care Agencies

Office Location

Street Address 1500 BRAGG BLVD STE 104
City FAYETTEVILLE
State NC
Zip Code 28301-4289

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134726219 Jenna Michelle Odneal Behavior Technician 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 2020-10-02
1790390094 Jessica Shellman Counselor 408 Person St. Ste 103, Fayetteville, NC 28301 2020-09-14
1487205951 Martha K Richardson Technician 720 Teachers Dr, Fayetteville, NC 28301 2019-09-25
1013568161 Angela Rena Locklear Counselor 211 Lamon St, Fayeteville, NC 28301 2019-09-20
1619535747 Teresa Wilson Contractor 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 2019-06-04
1912461815 Catherine Stevenson Nwogalanya Community Health Worker 1103 Hillsboro St., Fayetteville, NC 28301 2019-01-24
1811443187 Michael Carroll Counselor 308 Peterson Place, Fayetteville, NC 28301 2016-08-28
1023499886 Latifa Fedai Nurse Practitioner 380 Person Street, Fayettevill, NC 28301 2015-06-17
1265868939 Aci Support Specialists Community/Behavioral Health 1725 Venna Drive, Fayetteville, NC 28301 2013-09-25
1871929547 Aci Support Specialists Day Training, Developmentally Disabled Services 2820 Copenhagen Drive, Fayetteville, NC 28301 2013-09-25
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Taxonomy Information

Taxonomy Code 253Z00000X
Grouping Agencies
Classification In Home Supportive Care

Taxonomy Definition

An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.
Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487252219 Tera Campbell In Home Supportive Care 159 Dortmund Dr, Fayetteville, OH 45118-9406 2020-10-14
1568077485 Pmp Home Care Agency Inc In Home Supportive Care 5329 Yadkin Rd Ste B, Fayetteville, NC 28303-3254 2020-09-09
1609481571 Valley Care LLC In Home Supportive Care 2978 Cumberland Rd Ste 102, Fayetteville, NC 28306-2373 2020-09-08
1184236564 Health & Home Services, Inc. In Home Supportive Care 2411 Robeson Street, Suite 100, Fayetteville, NC 28305-5577 2020-08-18
1609487487 Living Private Home Care, LLC In Home Supportive Care 101 Devant St Ste 105a, Fayetteville, GA 30214-2711 2020-08-13
1063038792 Dianna Marie Anderson In Home Supportive Care 101 Old Sandy Creek Rd Ste B, Fayetteville, GA 30214-4546 2020-06-18
1487279485 A Clear Look Coaching Agency, LLC In Home Supportive Care 4582 Cumberland Rd Ste 104, Fayetteville, NC 28306-2416 2020-06-15
1679198899 A Clear Look Coaching Agency, LLC In Home Supportive Care 910 Hay St, Fayetteville, NC 28305-5314 2020-06-12
1356965164 Kedra Daniel In Home Supportive Care 435 Brenda Ln, Fayetteville, GA 30214-1505 2020-06-08
1932731700 Light of The World Home Care LLC In Home Supportive Care 3069 Cumberland Rd Ste 104, Fayetteville, NC 28306-6819 2020-02-10
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Competitor

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City FAYETTEVILLE
Zip Code 28301

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Dataset Information

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.

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