CCN: 097081 NPI: 1811194061 Organization

Revival Homecare Agency, DC

1101 MERCANTILE LN , SUITE 292
UPPER MARLBORO, MD 207745360

Contact Information

Phone 8882256994
Fax 8885923644
Enumeration Date 2007-06-29
Last Updated 2021-10-02

Taxonomies

Code: 251E00000X (Primary) License State: MD License: HH7047

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 6

providerType 36

censusDivision 6

providerType 36

censusDivision 6

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 47894

providerType 36

operatingCostToChargeRatio 1.0

specialPaymentIndicator

carrierCode 12202

localityCode 01

cbsaActualGeographicLocation 47894

providerType 36

operatingCostToChargeRatio 1.0

specialPaymentIndicator

carrierCode 12202

localityCode 01

cbsaActualGeographicLocation 47894

providerType 36

operatingCostToChargeRatio 1.0

specialPaymentIndicator

carrierCode 12202

localityCode 01